Registered Nurse Utilization Management

Job Summary

A company is looking for a Utilization Management Nurse.

Key Responsibilities:

• Initiating the continuum of care process for neonatal admissions
• Interacting with hospital staff to collect clinical information for medical necessity determinations
• Coordinating discharge planning needs for newborns and authorizing services requiring prior authorization

Required Qualifications:

• Registered Nurse (RN) with a current, unrestricted license
• Three or more years of clinical experience as a nurse in a Level III or Level IV NICU
• Three or more years of experience in a concurrent review or discharge planning role within a health plan or acute facility
• Experience with data entry into a database or EHR
• Willingness to provide weekend and holiday coverage occasionally