Quality Utilization Reviewer I

  • Birmingham, AL
  • Utilization Management
  • On-call/Flexi - Day shift - 8a- 4:30p - Monday- Friday
  • Nursing
  • Req #: 314466
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  • Job Summary
    • The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for Medicaid and commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with approval of UM Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If position becomes available).
  • Education
    • Graduate of an accredited School of Nursing or Social Work.
  • Experience
    • 2 years experience in hospital setting or related field (i.e. 3rd party payer)
    • Utilization review experience preferred.
  • Licensures, Certifications, and/or Registries
    • Current AL licensure as LPN, RN or LCSW

Additional Information

Main Campus Children's of Alabama
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