Quality Utilization Reviewer I - Childrens Hospital of Birmingham

• 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

PI251233429