Responsible for utilization review work for emergency admissions and continued stay reviews, the full-time State Licensed Utilization Review Nurse will evaluate electronic medical records, apply clinical guidelines, and engage with emergency department physicians while working remotely. Key responsibilities Review and evaluate electronic medical records of emergency department admissions for medical necessity using InterQual or MCG criteria Participate in telephonic discussions with emergency department physicians regarding documentation and admission status Analyze utilization patterns and trends to identify problems or inappropriate resource use Required qualifications Current and unrestricted RN license At least 3 years of clinical experience in an acute care setting, specifically in emergency room, critical care, and/or medical/surgical nursing A minimum of 2 years of utilization management experience in acute admission and concurrent reviews Intermediate level experience with InterQual and/or MCG criteria within the last two years Proficiency in medical record review in an electronic medical record (EMR) system