Registered Nurse - Utilization Review Coord - Psychiatric Medical Unit
Employment Type
Shift
Position Summary
Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to payors ensuring proper reimbursement for care. In collaboration with members of the health care team, conducts observation, admission, concurrent, discharge and retrospective reviews to evaluate the appropriate level of care, continued stay, and status of discharge planning.
What you will work:
- Full time
- 40 hours per week
- 11:00 PM - 7:30 AM
- Remote
What you will do
- Perform all aspects of utilization review to ensure the medical necessity of acute care hospitalization has the existence of supportive documentation in the EMR
- Provide all external review organizations the information necessary to complete reviews and effect maximum financial reimbursement
- Collaborate with Case Management
- Provides consultation and information to physicians, case managers and other members of the health care team
What you will need
- Bachelor of Science in Nursing (BSN)
- Current State of Michigan Registered Nurse License
- Three years acute care as a RN
- Preferred: Two years recent acute care utilization management experience, experience in facility audits/appears and processes
- Ability to work autonomously with little direction and be accountable for outcomes
What you will work
- Full time
- 40 hours per week
- Night shift
Our Commitment
Not included in the source posting: about the role, what you'll do, qualifications, benefits.
Who can apply
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