Utilization Review Specialist

Job Description

Job Summary: The Utilization Management Department is seeking a full-time Registered Nurse for the AM shift (7:30 am – 4 pm). The role involves reviewing medical records for admissions and continued stays, collaborating with healthcare providers, and communicating with third-party payors for authorization. The nurse will assist in denial management and ensure compliance with regulatory guidelines.

Qualifications:

• Education: ADN, Diploma Nursing Degree, or BSN
• Experience: Minimum 3 years in an acute care hospital
• Licensure: Current RN license in South Carolina

Benefits: Day one medical, dental, and life insurance, 403(b) match plan, tuition reimbursement, and more.

Equal Opportunity Employer: Committed to a discrimination-free environment.