Utilization Review Nurse
Job Description
A Utilization Review Nurse evaluates patient care plans for medical necessity and adherence to guidelines, ensuring effective resource use within healthcare organizations. Responsibilities include analyzing clinical data, coordinating with healthcare providers, and documenting findings. Required skills encompass critical thinking, communication, and clinical expertise. Typically working in hospital settings or insurance companies, they collaborate with physicians, case managers, and administrators. Career progression may lead to roles such as healthcare consultant or management positions.