VFMC is a specialty hospital committed to providing high-quality care to individuals facing substance use disorders combined with medical comorbidities. We are currently seeking a skilled Utilization Review Nurse or Registered Nurse (RN) to join our team. If you have a passion for ensuring patients receive the right care at the right time, we invite you to apply and contribute to our mission of improving lives through compassionate healthcare at our corporate office in Lakewood NJ. Looking to get off the busy inpatient floor but still looking to use your skills as a Registered Nurse? Position Overview: As a Utilization Review Nurse specializing in substance use disorders, you will be responsible for conducting thorough reviews of patient charts to assess medical necessity and obtain authorizations for necessary treatments. Your expertise will be crucial in ensuring that our patients receive optimal care. What you will do: Review patient charts to assess the medical necessity of ongoing treatment at a hospital level of care. 2. Collaborate with healthcare providers to gather necessary clinical information for authorization purposes. 3. Communicate effectively with insurance providers to obtain timely authorizations for treatment services. 4. Update our EMR system with newly obtained authorization number and adjust the level of care. What you should have: 1. Registered Nurse (RN) with a valid and current license. Acute care experience. 2. 1 year of experience in utilization review preferred. 3. Strong understanding of medical necessity criteria and authorization processes preferred. 4. Excellent communication and interpersonal skills. 5. Detail-oriented with strong organizational and chart review skills. Schedule: M-F 9-5p Valley Forge Inc
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