As our Utilization Review Author (UR Author) - RN Required, you will be part of our Physician Advisory Team providing first-level initial admission and continued stay case reviews. The Utilization Review Author will determine the appropriate cases for review, utilizing client-specific guidelines. After identifying a case, the Utilization Review Author will ensure appropriate orders and clinical documentation are in place before applying the evidence-based criteria.  The successful candidate will have hospital-based Utilization Review or Case Management experience. **Flexible Schedule with some weekend requirements throughout the month* Responsibilities: - Perform initial admission and continued stay reviews utilizing InterQual and MCG using evidenced-based criteria to identify and support the appropriate level of care - Abstract data from a variety of medical records to ensure accurate clinical data - Adhere to established quality, timeliness, and productivity outputs required in the completion of first-level nursing utilization review - Ensure effective communication internally and externally while delivering excellent customer service - Perform other duties as assigned by departmental leadership in support of departmental and organizational strategies and goals, which may include system testing, training, and other opportunities that promote growth - Complete and maintain annual compliance and annual HIPAA training - Participate in organizational educational offerings and required training as needed to support service delivery Required Qualifications: - Must have a current Registered Nurse license in your state of residence - Bachelor’s Degree - At least 2 years of recent hospital-based Utilization or Case Management Experience is preferred - At least 3 years of clinical nursing experience (practice)   - Knowledge of current Medicare rules and regulations related to Utilization Review  - Strong analytical, organizational and time management skills - Ability to work independently with limited supervision  - Excellent written and verbal communication skills - Excellent clinical abstraction and attention to detail  - Experience with InterQual and/or MCG is preferred - Must be willing to work a variable schedule that encompasses evenings, days, weekends, and holidays (Coverage Hours: 7:00 AM-12:00 AM EST) For this US-based position, the base pay range is $65,478.00 - $96,885.29 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a target of 10.00%