Job Description
PE Global Healthcare are recruiting for a Utilisation Review Nurse for a sought after employer based in Cork This opportunity is a Temporary Contract approx 12 months. It may suit a candidate who would like to gain experience applying clinical skills in a business setting. 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. Clinical Evaluation of Claims to ensure treatment was carried out in the appropriate setting with an appropriate length of Stay and recourses Identify areas of inefficient practice and arrange engagement and collaboration with providers to implement change Responsibility for interrogating reports and analysing Claims Activity to identify and highlight areas for improvement in practice Attendance at internal team meetings and with hospital and consultants when required Liaise regularly with Clinicians Update monthly reports on utilisation review. Draft letters, papers and presentations in relation to the clinical area as required. Awareness of market changes in the medical field REQUIRED: Current Registration with the NMBI Minimum of 5 years acute clinical experience. 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: 40% in office / 60% remote 10% Performance related bonus Health insurance Pension Please call Claire PE Global Healthcare or email ***Please note our clients cannot assist with any visa sponsorship and candidates must have the correct visa to live and work in Ireland*** 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. To view all PE Global Healthcare roles, visit Register today to keep your finger on the Job Opportunity Pulse. Although it is not possible for us to respond to all applications, we at PE Global will do our upmost to give you feedback on your application. You have sent your Cv into us as a company and even though you have sent your CV to a particular position, we are making the reasonable assumption that you are active on the job market and as part of our normal recruitment service we will discuss other suitable positions with you. You are free to opt out of this so please specify in your application to us if you just want to be contacted in relation to a specific vacancy. Your Cv is sent to a central recruitment inbox which a number of people in the applicable PE Global division have access to and so this means that you might not be contacted by the named person in this advert. Skills: Registered General Nurse Clinical Nurse Manager NMBI