RN Utilization Review Specialist – Nights (Inpatient Care)

Onvida Health is seeking an RN Utilization Review Specialist to perform prospective and concurrent medical record reviews to determine medical necessity and appropriate level of care in line with CMS regulations and payer requirements.

You will communicate with payers to obtain authorizations, support appeals, and educate clinicians on documentation standards to ensure compliant, efficient care and optimal reimbursement.