Key Family of Companies
  • AHDI
  • Indianapolis, IN, USA
  • Full Time

We are excited to welcome a Full-Time Utilization Review Nurse (RN) at our Indianapolis, IN 46250 location to our growing team! This is a remote (work from home) position. Key Benefit Administrators is consistently named a Top Workplace by our employees year after year, and we would love to learn more about you and your career goals through this application process!

Creating a Top Workplace is about more than offering great benefits and vacation time. It's about organizational health. Employees want to align with the company's vision, be challenged by a high-performance culture, and feel that they are valued and that their voices are heard.

At Key Benefit Administrators, we believe in delivering a Wow level of service to our valued clients and living up to our mission of improving people's health through high quality, cost-effective care. Family culture, supportive work relationships, high quality training and personal development are part of our DNA and we are looking for the right individual to join us!

If you are passionate about delivering high quality service and would like to be part of our supportive family culture – we want to hear from you. The Utilization Review Nurse position includes a comprehensive benefit package, award-winning training program and competitive salary!

Utilization Review Nurse Overview: The Utilization Review Nurse provides excellence in Utilization Management for AHDI and Key Family clients, to ensure patients are receiving the highest quality care at the most appropriate level of care.

Utilization Review Nurse Essential Duties and Responsibilities:

  • Performs telephonic and record reviews to assess the medical necessity of elective and emergent admissions and continued stays, based on severity of illness and intensity of service, criteria. Enters that data in the computer in an accurate and timely manner.
  • Ensures that the quality of care delivered meets professionally recognized standards of health care.
  • Ensures that the services performed are reasonable, medically necessary and delivered in the appropriate setting.
  • Implements the HCM physician review process, referring cases not meeting admission, continued stay or pre-determination criteria to the medical director.
  • Interacts with hospital UR/CM, providers, physician's offices, families and members, to facilitate the precertification process.
  • Communicates with the AHDI/HCM Case Managers regarding patients with potential Case Management needs.
  • Runs and/or reviews reports for accuracy on a daily and/or monthly basis as needed.
  • Perform other work-related duties as assigned.

Utilization Review Nurse Competencies, Knowledge, Skills and Abilities:

  • Registered Nurse, with a current, unrestricted license
  • Strong clinical background – preferably 3-5 years of experience in acute care or skilled or rehabilitative clinical settings.
  • Polished communication skills both oral & written. Speaks clearly and persuasively in positive or negative situations. Writes clearly and informatively.
  • Good data entry and basic computer skills, proficient in Microsoft Word, Excel & Outlook, with the ability to quickly learn new applications.
  • Able to work independently and as a part of a team.
  • Ability to work in a proficient and timely manner in to meet service expectations.
  • Professional business demeanor.
  • Strong work ethic
  • Ability to maintain confidentiality

A background in Precertification and/or Case Management is required.

More about Key Benefit Administrators:

KBA is a privately owned company with a family atmosphere and supportive leadership, and we take an active role in our local communities with corporate sponsorships and community outreach programs. Employees continue to vote KBA as a Best Place To Work year after year! https://topworkplaces.com/company/key-benefit-administrato/indystar/

Founded in 1979 as a full-service group benefits administration firm specializing in self-funded medical plans, the Key Family has grown to become one of the country's largest independently owned third party administrators, supporting a wide variety of group benefit plans.

Learn more about KBA here: https://keybenefit.com/

Our Mission: To create happy customers who renew by improving upon our successful track record of applying patented, proven, creative solutions to the reduction of healthcare costs while improving people's health through high quality, cost-effective care.

Check us out on Glassdoor! https://www.glassdoor.com/Overview/Working-at-Key-Benefit-Administrators-EI_IE692314.11,37.htm

If you are unable to complete an application for the Utilization Review Nurse position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process.

All qualified applicants for the Utilization Review Nurse position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

If you are unable to complete an application due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process

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