Utilisation Review Nurse, Cork

Full time
Job level
Qualified (non-manager)
13 Sep 2019
10 Mar 2020

Job Description

Utilisation Review Nurse, Cork


An exciting opportunity has arisen to join our medical practice team in the role of Utilisation Review Nurse.

The primary function of the Utilisation Review Nurse will be reviewing claims to ensure efficiency and cost containment and making decisions on claims utilisation following evaluation of medical guidelines and benefit determination. 

 Major duties and responsibilities within the role are:

  • Retrospective Clinical Evaluation of Claims to ensure treatment was carried out in the appropriate setting with an appropriate Length of Stay. 
  • Involved in setting of fees in the Schedule of Procedures for Professional fees
  • Provide Clinical training to non -clinical personnel
  • Provide Clinical advice and support to the Business
  • Attendance at meetings with hospital and consultants 
  • Liaise with Clinicians on a daily basis 
  • Responsibility for reporting and analysing practice in Claims Activity.     
  • Awareness to market changes in the medical field
  • Completion of any ad hoc duties which may be requested as part of the daily running of the MedicalPractice Team 

This role reports to the Medical Practice Manager


  • Registered General Nurse with a minimum of 3 years hands on clinical experience.
  • Computer skills and Presentation Skills
  • Have the ability to be pro-active and decisive in analysing practice and implementing better ways of working creating efficiencies. 
  • Confident in dealing with clinicians



Apply in Confidence;

Catriona Kelly – Cpl Healthcare

Ph: + Apply

E: Apply



Ref: JO-1803-405700_9

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This job was posted to A&E nurse, Ward nurse in Cork

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