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The RN Utilization Review Specialist improves the quality and completeness of clinical documentation by performing concurrent reviews of medical records. They provide education to physicians and identify process improvement opportunities to enhance patient outcomes.
Candidates must have an Associate Degree in Nursing and two years of experience in an acute care setting. A current RN license in Alabama or a Multi State RN License is required, along with proficiency in word processing and spreadsheet programs.
Overview Qualifications Minimum Qualifications: Associate Degree in Nursing 2 of the most recent 4 years’ working in an acute care setting Proficient in word processing and PC based spreadsheet programs Licensure, Registration, Certification: One of the following: Current Alabama RN license Current Multi State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama* *Infirmary Health abides by the NLC requirements and guidelines for the state of Alabama For specific areas CRRN (Certified Rehabilitation RN) is required (or eligibility) Desired Qualifications: BSN Some background in management, clinical education or case management Desired Licensure, Registration, Certification: National certification applicable to area of clinical practice Responsibilities Improves overall quality and completeness of clinical documentation by performing concurrent review of the medical record to ensure medical necessity and appropriateness of hospital admissions. Provides education to physicians and others to improve the capture of clinical severity for the level of service rendered. Identifies process improvement opportunities and supports the timely and accurate capture of measurements to improve patient outcomes.
This job posting was last updated on 10/11/2025