RN-Utilization Review Cover Letter

RN-Utilization Review Cover Letter

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15 RN-Utilization Review cover letter templates

What to include in a Cover Letter
1
Company Address
2
Salutation
3
Compelling Details
4
Respectful Closing

How to Write the RN-Utilization Review Cover Letter

309 Roberto Green
Norahaven, MN 18424
Dear Phoenix Kertzmann,

I am excited to be applying for the position of rn-utilization review. Please accept this letter and the attached resume as my interest in this position.

In my previous role, I was responsible for regulatory and compliance updates to staff, provides standards of practice updates, initiates / drives process changes to ensure compliance to such regulations and quality initiatives as it relates to Utilization Review.

Please consider my qualifications and experience:

  • Currently licensed Registered Nurse
  • Competency in personal computer skills including Microsoft word, Outlook and Internet
  • Completes staff quality audit reviews
  • Physician group experience preferred
  • Prior clinical experience an acute care, skilled or rehabilitation clinical setting
  • Experience in Utilization Management, Medicare and/or Medicaid guidelines
  • Evaluates new admissions and continued stay for medical necessity using approved criteria through the utilization of the electronic medical record
  • Bachelors of Science in Nursing (BSN) -or- a combination of education and applicable experience

Thank you for considering me to become a member of your team.

Sincerely,

Blake Jakubowski

Responsibilities for RN-Utilization Review Cover Letter

Rn-utilization review responsible for direction and oversight for the day to date operations of the centralized utilization review management, telephonic utilization review, prior authorization functions, and support case management programs.

Experience in utilization review or review for medical necessity
Experience in activities ensuring patients meet criteria for appropriate level of care
Experience in utilization review or reviews for medical necessity
Medicare and Medicaid Utilization Review knowledge
Working knowledge of Medicare guidelines pertinent to inpatient hospital and ambulatory services
Registered Nurse (RN) or Licensed Vocational Nurse (LVN) – license in California (active, no restrictions)
The work from home nurse will be making case management decisions for the member population in California
Knowledgeable of Medicare and CMS guidelines

RN-Utilization Review Examples

Example #1

Example of RN-Utilization Review Cover Letter

36185 Ferdinand Mount
West Gilbert, CT 43882
Dear Landry Senger,

Please consider me for the rn-utilization review opportunity. I am including my resume that lists my qualifications and experience.

In the previous role, I was responsible for feedback to Facility Case Management Director and Division Director of Case Management on issues related to utilization review and authorization/denial operations: offers input to Division Director on managed care contracting issues; best demonstrated practices; process improvement and utilization management activities; barriers to achieving goals and objectives of initiatives; participates in HCA Case Management and Division initiatives.

Please consider my experience and qualifications for this position:

  • Minimum 1-2 yr Utilization Review experience preferred
  • Proficiency with MS Office products such as Word, Excel, Outlook, and multiple systems
  • Experience working in Behavioral Health
  • Experience with Utilization Review and Mother/Baby strongly preferred
  • Graduation from an accredited school of nursing with current licensure in the State of Indiana
  • Thorough knowledge of medical and ancillary services necessary to utilize screening criteria as measured against the documented medical record with respect to patient needs for medical and health care
  • Knowledgeable regarding medical terminology, appropriate levels of care, treatment and modalities, and the health care delivery system
  • Knowledge of Interqual and Milliman guidelines /criteria, CMS and Joint Commission requirements related to corporate compliance

I really appreciate you taking the time to review my application for the position of rn-utilization review.

Sincerely,

Royal Beahan

Example #2

Example of RN-Utilization Review Cover Letter

6174 Barrows Parks
Myratown, NH 07786-3776
Dear Landry Parker,

Please consider me for the rn-utilization review opportunity. I am including my resume that lists my qualifications and experience.

In the previous role, I was responsible for day-to-day oversight of Utilization Management operations, ensuring all practices and programs are aligned with the management team, directs the policies and procedures, and standards for utilization management operations.

Please consider my experience and qualifications for this position:

  • At least 6 months hospital utilization management using Interqual or MCG
  • Verbal, Grammar
  • Interpersonal, Customer relations
  • Mathematical, Reading, Comprehension
  • Utilization review management experience preferred
  • Prior Utilization Review experience from hospital or insurance company, preferred
  • Competency in relationship building and social interactions
  • Openness to change and willingness to try new approaches to problem solving

Thank you in advance for taking the time to read my cover letter and to review my resume.

Sincerely,

Lennon Wolf

Example #3

Example of RN-Utilization Review Cover Letter

1069 Candis Ways
Wallyfort, TX 15472-1164
Dear Frankie Blanda,

I am excited to be applying for the position of rn-utilization review. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for information regarding utilization management requirements and operational procedures to Care Coordinators, providers and facilities.

My experience is an excellent fit for the list of requirements in this job:

  • Familiar with Utilization Management, Insurance Contracts, Documentation requirements and Appeals
  • Valid unencumbered Texas RN licenseCompetent in Microsoft software
  • Superior clinical judgement
  • Current RN license issued by the State of New Hampshire Board of Nursing
  • Strong knowledge of clinical UR and QA, Medicaid, Medicare guidelines and covered services
  • Strong knowledge of InterQual/Milliman, MCG, ICD 10 Codes, and MCG Criteria
  • Working knowledge of behavioral health, substance abuse and human service resources
  • Assist non-clinical staff in performance of administrative reviews

Thank you for taking your time to review my application.

Sincerely,

Azariah Lemke

Example #4

Example of RN-Utilization Review Cover Letter

73391 Maybell Dam
East Carmeloberg, WY 61853-9993
Dear Brooklyn Padberg,

Please consider me for the rn-utilization review opportunity. I am including my resume that lists my qualifications and experience.

In the previous role, I was responsible for pharmacist support for the drug prior authorization program by providing clinical expertise to Prior Authorization technician team to ensure review of prior authorization requests within all regulatory required time frames.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

  • Serves as a presentation guide for walk-through surveyors, auditors, group representatives
  • Graduation from an accredited school of nursing with current IN RN licensure in the State of Indiana
  • Strong technology skills, being able to work out of multiple systems at one time
  • Previous experience in utilization management and/or case management
  • Experienced with MCG (Formerly Milliman) or Interqual
  • Registered nurse with current MN license without restrictions or pending restrictions
  • Familiar with process of reviewing cases for medical necessity
  • Minimum Bachelors in Nursing, Master in Nursing or Public Health preferred

Thank you for your time and consideration.

Sincerely,

Armani Powlowski

Example #5

Example of RN-Utilization Review Cover Letter

516 Mohr Mission
Cindieburgh, UT 59555
Dear Rowan Beier,

I submit this application to express my sincere interest in the rn-utilization review position.

Previously, I was responsible for strategic direction across functional responsibilities in accordance with requirements; regulatory, URAC, HEDIS, NCQA and future business related standards.

Please consider my qualifications and experience:

  • Completion of RN program or related health care curriculum
  • Demonstrates analytical and critical thinking abilities with proactive decision-making and negotiation skills, strong knowledge of governmental and private organization and community resources
  • Minimum High School graduate or GED equivalent.- LPN or RN license in State of Arizona with business/revenue cycle experience preferred or equivalent experience in both a business and clinical setting
  • Excellent interpersonal communication, conflict resolution, and negotiation skills are necessary
  • Understanding of pre-acute and post-acute venues of care and post-acute community resources preferred
  • Computer knowledge/experience is preferred
  • Knowledge and background with Joint Commission and CMS CoP is highly beneficial
  • Case Management Certification (ACMA)

Thank you in advance for taking the time to read my cover letter and to review my resume.

Sincerely,

Marion Crist

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