Utilization Review RN

Are you a Registered Nurse (RN) looking for your next career adventure? We invite you to join our Case Management team as Utilization Review Nurse!

Kingman Regional Medical Center (KRMC) is located in beautiful northwest Arizona.

Experience the magic of Kingman's stunning Arizona sunsets and thrive in an outdoor enthusiast's dream destination with picturesque mountain ranges, nearby lakes, vibrant parks, and plenty of outdoor activity.  Kingman is an incredible community to live, work, and play! 

Position Purpose: The Utilization Review Nurse performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities.

The UM Nurse has an emphasis on the review, analysis, monitoring, and operation of the patient medical care plans and works toward optimal clinical, financial, operational, and satisfaction outcomes. 

Hours/Shift: Full Time/Days M-F 8:00a-4:30p 

Benefits: We offer you an excellent total compensation package, including a competitive salary, comprehensive benefits, and growth opportunities.

We invest in you!


* Exceptional Colleagues
+ Join us and you'll be a part of a culture where we support each other and celebrate what makes each of us a special person as we work together with integrity, compassion, teamwork, respect, and accountability
+ Our leaders demonstrate their commitment by gathering feedback, supporting, and empowering team members to do their best work through regular leadership rounding


* Health and Well-Being
+ Medical, Dental, Vision, Employer Paid HSA for HDHP participants, Robust Wellness and Employee Assistance Program, Employer Paid Group Life, Short & Long-Term Disability
+ Generous Paid Leave Accruals and PTO Cash Out Opportunities
+ 403b Retirement Plan with Employer Contributions
+ Employee Recognition Programs, Employee Discounts, and Employee Referral Bonus Program
+ Employee Identity Theft Protection
+ On-site daycare exclusive to our employees’ children of all ages


* Career Growth and Development 
+ Tuition Reimbursement/Scholarships for full-time employees
+ As a not-for-profit organization, our employees who have qualified student loans may be eligible for the Public Service Loan Forgiveness program 


* So much more!

Key Responsibilities:


* Conducts medical necessity reviews for Medicare, Medicaid, self-pay, and other insured patients.


* Verifies physician orders per Medicare and payer guidelines and ensures documentation reflects patient acuity accurately.


* Coordinates with medical staff, Case Managers, and Insurance Specialists to facilitate clear communication with payers, ensuring timely, accurate information.


* Consults with the Physician Advisor for complex cases and engages in denial management.


* Documents utilization review activities in the M...