Registered Nurse - Behavioral Health Unit - Utilization Management
About The Position
Performs utilization review of inpatient admissions, outpatient surgeries, and ancillary services. Performs precertification, concurrent and retrospective reviews, and coordination of discharge planning. Determines medical necessity and appropriateness of services using clinical review criteria. Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum. Acts as a member advocate by expediting the care process through the continuum, working in concert with the health care team to maintain high quality and cost effective care delivery.
Requirements
- Requires an Associates of Nursing (ASN).
- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
- Requires that the RN has graduated from a nationally accredited nursing program.
- Requires 3-5 years of relevant experience.
- Basic Life Support certification through the AHA or other advanced life support certifications may be required per unit/department specialty according to patient care policies.
- Requires proficiency in Microsoft Office and applications.
- Requires understanding of medical record requirements, regulations and policies.
Nice To Haves
- Bachelors of Nursing (BSN) preferred.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
