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Internship Rn Utilization Review Nurse Jobs in Tennessee

RN Utilization Review

Knoxville, TN · On-site

$63K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. * Apply your RN clinical knowledge ...

RN Utilization Review

Memphis, TN · On-site

$63K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. * Apply your RN clinical knowledge ...

RN Utilization Review

Nashville, TN · On-site

$63K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. * Apply your RN clinical knowledge ...

Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift Covenant ... Prepares and reviews necessary documentation for insurance utilization management processes and ...

Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift ... Prepares and reviews necessary documentation for insurance utilization management processes and ...

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Internship Rn Utilization Review Nurse information

What are the key skills and qualifications needed to thrive as an Internship RN Utilization Review Nurse, and why are they important?

To thrive as an Internship RN Utilization Review Nurse, you need a solid foundation in nursing principles, clinical assessment, and case management, typically supported by an RN license and current enrollment in a nursing program. Familiarity with medical coding systems (like ICD-10 or CPT), electronic health records (EHRs), and utilization review software is often required. Strong analytical thinking, communication skills, and attention to detail set candidates apart in this role. These competencies are crucial for ensuring appropriate patient care, regulatory compliance, and effective resource utilization within healthcare organizations.

What types of tasks and learning experiences can I expect as an Internship RN Utilization Review Nurse?

As an Internship RN Utilization Review Nurse, you will typically assist experienced utilization review nurses in evaluating patient records, verifying the necessity of medical procedures, and ensuring compliance with insurance or regulatory guidelines. You'll gain exposure to interdisciplinary communication by collaborating with physicians, case managers, and insurance representatives. This role provides valuable insight into how clinical decisions impact both patient outcomes and healthcare costs, helping you develop analytical and communication skills essential for future advancement. Expect to participate in chart reviews, learn about medical necessity criteria, and attend case discussions as part of your hands-on learning.

What is an Internship RN Utilization Review Nurse?

An Internship RN Utilization Review Nurse is a registered nurse who is in a training or internship phase to learn how to evaluate the necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient records, coordinating with healthcare providers, and ensuring that treatments meet established guidelines and insurance requirements. The internship provides hands-on experience in the field of utilization review, helping nurses transition from direct patient care to a more administrative or case management-focused role. It is an entry-level opportunity for RNs interested in healthcare quality and cost management.

What is the difference between Internship Rn Utilization Review Nurse vs Utilization Review Nurse?

AspectInternship Rn Utilization Review NurseUtilization Review Nurse
CredentialsRN license, internship or training programRN license, certification in utilization review often preferred
Work EnvironmentTraining setting, supervised, learning-focusedClinical or office setting, independent review tasks
Job ResponsibilitiesAssisting in review processes, gaining experiencePerforming utilization reviews, making coverage decisions

Internship Rn Utilization Review Nurse is a training role for nursing students or new graduates gaining experience, while Utilization Review Nurse is a full-time professional responsible for evaluating medical necessity and coverage. The internship role focuses on learning, whereas the utilization review nurse performs independent assessments in healthcare settings.

What are the most commonly searched types of Rn Utilization Review Nurse jobs in Tennessee?

The most popular types of Rn Utilization Review Nurse jobs in Tennessee are:

What cities in Tennessee are hiring for Internship Rn Utilization Review Nurse jobs?

Cities in Tennessee with the most Internship Rn Utilization Review Nurse job openings:

Full-time

Re-posted 18 days ago


Baptist Memorial Health Care rating

7.3

Company rating: 7.3 out of 10

Based on 113 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers


Job description

Description
Job Summary
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities
  • Utilization Review
  • Discharge planning
  • Readmission Reduction Participation
  • Payer Communication and denial reduction
  • Completes assigned goals.
Specifications
Experience
Minimum Required
  • RN with at least one (1) year of clinical experience
Preferred/Desired
  • RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Education
Minimum Required
  • Diploma or Associate Degree in Nursing
Preferred/Desired
  • BSN or MSN
Training
Minimum Required
Preferred/Desired
  • Certified Case Manager
Special Skills
  • .
Minimum Required
  • Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Preferred/Desired
  • Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Licensure
  • RN
Minimum Required
  • RN
Preferred/Desired
  • RN;CCM;ACM

What Baptist Memorial Health Care employees say

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Benefits

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About Baptist Memorial

Sourced by ZipRecruiter

Baptist Memorial, based in Memphis, TN, US, is a leading health care organization renowned in the healthcare industry. The company's official website is baptistonline.org which provides a comprehensive view of their services and operations. Baptist Memorial operates a myriad of hospitals, health clinics, and medical facilities providing expert and compassionate care. Founded in 1912, it has a rich legacy of over a hundred years of dedication to its community, offering services which include acute care, diagnostic services, and a broad range of speciality health services fulfilling various patient needs.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Memphis, TN, US