Utilization Review Registered Nurse_Days
Norfolk, Virginia, 23500, USA
Listed on 2026-02-03
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Nursing
Healthcare Nursing, RN Nurse, Clinical Nurse Specialist
As an integrated care manager, specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review. Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements. Responsible for written and /or verbal communication of pertinent clinical information.
Virginia Remote, must be available to come into Virginia Beach office as required
Responsibilities- Perform utilization review services within licensure scope, including prior authorization for inpatient and outpatient reviews (initial and concurrent continued stay).
- Review the appropriateness of treatment settings to ensure compliance with applicable criteria and regulatory requirements.
- Communicate pertinent clinical information (written and/or verbal).
- Minimum of 3 years acute care experience
- Registered Nurse
- Verbal and Written Communication, Critical Thinking, Proficiency with basic computer skills
- VA RN License (VABON) or North Carolina RN License (NCBON)
- RN diploma, RN Associate Degree, RN Bachelor Level Degree or RN Master Level
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
Benefits- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Long-Term, Short-Term Disability, and Critical Illness plans
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
For positions that are available as remote work, Sentara Health employs associates in the following states:
- Alabama
- Delaware
- Florida
- Georgia
- Idaho
- Indiana
- Kansas
- Louisiana
- Maine
- Maryland
- Minnesota
- Nebraska
- Nevada
- New Hampshire
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Pennsylvania
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
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