telecommute Nurse
making it REMOTELY Possible

utilization review

Utilization Review Nurses perform medical reviews for medical necessity and appropriate length of stay (if care is related to an inpatient admission).  These nurses receive incoming calls, or electronic transmission of medical data, from providers who are seeking authorization/approval for elective surgeries, emergent/direct inpatient admissions, concurrent admissions, retrospective admissions, DME, outpatient skilled Home Health Care or Hospice, etc.  UR (Utilization Review) Nurses use criteria designated by the employer such as Milliman and Robertson Care Guidelines, to review, approve and/or not approve healthcare services.  Telephonic UR Nurses are typically employed by Insurance Agencies and Managed Care or HealthCare Organizations.  They are also utilized by Worker’s Compensation employers.