University of Rochester Utilization Mgmt RN in Rochester, New York
Full Time 40 hours Grade 044 Utilization Management
8 AM-4:30 PM; WKENDS AS NEEDED
The Utilization Management Nurse role is a unique and exciting opportunity that blends the knowledge of nursing and the business aspects of the health care system. The position spans the entire health care system working collaboratively with Health Information Management, Financial Counselors, Patient Financial Services, providers, social work, patients, and various insurance companies. The UM RN is responsible for the review of clinical documentation utilizing evidence based criteria to support medical necessity, and appropriate level of patient care for services provided. The UM RN is also responsible for reviewing outcome trends and patterns to identify educational opportunities and performance improvement processes across the health care continuum. In addition, the UM RN is responsible for auditing the quality of clinical documentation and providing education based on findings. The role requires strong communications skills and critical thinking skills.
RN with Utilization Review experience required; 5 years acute hospital and clinical documentation experience preferred.
EOE Minorities/Females/Protected Veterans/Disabled
Job Title: Utilization Mgmt RN
Location: Strong Memorial Hospital
Job ID: 202501
Full/Part Time: Full-Time