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Brighton Rehabilitation & Wellness Center

Director of Utilization Review

Pay: Not specified

Posted: 1 week ago

Location: Beaver, PA (Onsite)

Last Updated: 5 days ago

Hours: Full-Time

Expires: 10/1/2026

Job Description

The Director of Utilization Review (UR) is to manage effectively and efficiently all aspects of the MDS/ Case management / Restorative/ Care planning/ 5 Star and Quality Measures while capturing clinical reimbursement. This should be done while following the RAI manual, DOH guidelines, CMS guidelines, Federal and State Guidelines and Corporate Compliance. 1) Graduate of an accredited School of Nursing with current Pennsylvania nursing license 2) Maintain CEU credits through seminars, in-service programs, and professional journals relative to professional growth 3) Strong knowledge of the RAI, MDS, state and federal guidelines, 5 star reporting and quality measures, and restorative nursing