Anne E. Turner

Utilization Review Nurse @ECU Health

Greenville, NC, US

Utilization review nurses perform frequent case reviews, check medical records, speak with patients and care providers regarding treatment, and respond to the plan of care. They also make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions. Furthermore, they also assist with determining whether a treatment meets the criteria for reimbursement by the insurance plan.Utilization review nurses are also found in discharge planning roles to ensure that patients make a safe transition from acute to home care. They are involved in pre-certification, which determines whether a recommended procedure, medication, or therapy is appropriate for an individual according to the guidelines of their insurance plan.

Western Carolina University

Bachelor of Applied Science (B.A.Sc.)