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Twin Falls, Idaho
Utilization Reviewer RN
OverviewSt. Luke's Health System in Twin Falls is seeking an Utilization Reviewer to join our Utilization Review team. The Utilization Reviewer - RN is responsible for evaluating medical necessity for patient hospitalization and acting as an internal resource for patient care. Ensures that utilization functions are complying with hospital procedures and federal regulations.Responsibilities Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not limited to surgical procedures, Medicare Part B medications, Long Term Services and Supports, and Home Health. Reviews the medical necessity of admission, continued hospitalization, length of stay, and an
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