RN UTILIZATION MANAGER

Employment Type

: Full-Time

Industry

: Healthcare - Nursing



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Job Description

Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing type, and medical necessity. This may include delivering notifications to patients directly. Interface is completed verbally, via email, data base tasks, or other electronic communication and via telephone.

Qualifications

Graduation from a state-accredited school of professional nursing or other professional degree with appropriate clinical and/or project management experience. If hired after October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a Bachelor's degree with a major in Nursing or a Master's degree with a major in Nursing within seven years of employment date.

Licensed to practice as a Registered Nurse in the state of North Carolina. Two (2) years of clinical experience in a medical facility and/or comparable Utilization Management experience.

Primary Location: Lenoir, North Carolina, United States

Department: 6100-17034-Behavioral Health Facility

Shift: Day Job


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