Utilization Mgmt RN

The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services. The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services. Education

• Graduate of an accredited nursing school Required
• Bachelor’s Degree of Science in Nursing Preferred
• Master’s degree Preferred

Work Experience

• 2 years of experience in an acute, post-acute or payer setting Required
• 3 years of utilization review or care management experience Preferred

Licenses and Certifications

• RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required

Piedmont Healthcare Corporate

Graduate of accredited nursing school required; 2 years acute, post-acute or payer setting experience required; RN Georgia State Licensure or NLC/eNCL Multistate Licensure required.

Key Responsibilities

• reviewing hospital admissions
• monitoring patient progress
• authorizing hospital stays

Job Details

• Category: Healthcare Services - Nursing
• Seniority: Mid Level
• Commitment: Part Time
• Workplace: Remote — Atlanta, Georgia, United States
• Languages: English

About Piedmont Healthcare Inc.

A healthcare provider ensuring appropriate hospital care and medical necessity. — Industry: Healthcare

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