Job Summary
A company is looking for a Utilization Management Nurse I (IOP).
Key Responsibilities
- Conduct initial admission reviews and monitor patient care to ensure appropriateness of services
- Consult with multidisciplinary teams and communicate review results to ensure proper reimbursement
- Collect and compile data in accordance with applicable policies and regulations
Required Qualifications, Training, and Education
- Bachelor's degree in Nursing from an accredited institution
- Five years of nursing experience, including two years in utilization or case management in a hospital setting
- Licensure as a registered nurse in South Carolina or a compact state
- Evidence of committee involvement within a healthcare setting
- Prior leadership experience preferred
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