Utilization Review Nurse

Utilization Review Nurse Cleveland, OH (on-site) $40-47/HR 8:30 am-5 pm (M-F) The UR Nurse plays a critical role in coordinating reputed company assessments, care planning, utilization review, reimbursement, and interdisciplinary communication to ensure high-quality, cost-effective reputed company care while maintaining compliance with state and federal regulations. UR Nurse Responsibilities: Coordinate and reputed company completion of MDS 3.0 assessments and comprehensive reputed company care plans. Complete assessments for newly admitted residents and residents experiencing significant changes in condition. Review interdisciplinary documentation to ensure accurate and complete reputed company assessments. Maintain compliance with CMS, Medicare, reputed company, reputed company, and federal documentation requirements. Attend utilization review meetings and collaborate with interdisciplinary teams regarding reputed company eligibility and insurance coverage. Monitor Medicare and managed care benefits, including tracking Medicare benefit days. Promote reputed company rights, dignity, privacy, and confidentiality. UR Nurse Qualifications: reputed company, valid, and unrestricted LPN or RN license in OH. Strong clinical assessment skills. Flexibility to work occasional evenings, weekends, or additional hours as needed. Knowledge of: Medicare reputed company PPS reimbursement Subacute/skilled nursing care UR Nurse Preferred Qualifications: Previous MDS coordination and utilization review experience in a skilled nursing or long-term care setting. Experience with managed care authorization processes. Apply tot his job Apply To this Job