Nurses , Medical Professionals & Healthcare

Utility Review Nurse

  • Full Time
  • Remote
  • Cork City
  • 41933561

PE Global Healthcare are recruiting for a Utilisation Review Nurse for a sought after employer based in Cork 

The primary function of the Utilisation Review Nurse will be reviewing claims to ensure efficiency and cost containment and making decisions on claims utilisation following evaluation of medical guidelines and benefit determination. Attend meetings to communicate and educate hospital personnel and consultants on the importance of managing patients efficiently in line with best practice.   

MAJOR DUTIES AND RESPONSIBILITIES.   

  • Retrospective Clinical Evaluation of Claims to ensure treatment was carried out efficiently in the appropriate setting with appropriate Length of Stay and appropriate services provided  
  • Provide Clinical advice and support to the Business
  • Attendance at internal team meetings and with hospital and consultants when required  
  • Liaise regularly with Clinicians 
  • Responsibility for reporting and analysing practice in Claims Activity.    
  • Update monthly reports on utilisation review. 
  • Draft letters, papers and presentations in relation to the clinical area as required.
  • Awareness to market changes in the medical field
  • Completion of any ad hoc duties which may be requested as part of the daily running of the Medical

REQUIRED:

  • A registered General Nurse with a minimum of 5 years hands on clinical experience.
  • Orthopaedic Experience desired
  • Computer skills and Presentation Skills
  • The ability to be pro-active and decisive in analysing practice and implementing better ways of working creating efficiencies.
  • Be confident when addressing issues with clinicians.

BENEFITS

  • Monday to Friday hours with extra benefit of Flexi Hours
  • Hybrid: 20% in office / 80% remote
  • 10% Annual Performance Bonus
  • Pension
  • Healthcare
  • Sick Pay
  • Maternity Benefit
  • Highly Competitive Salary

Please call Claire PE Global Healthcare 0818 222 018 / 083 208 5507 or email Claire.osullivan@peglobal.net

PE Global Healthcare specialises in providing contract and permanent Healthcare professionals to the private and public sector. PE Global Healthcare finds jobs for Healthcare Staff in all specialties in Ireland.

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