Registered Nurse - Utilization Review, Per Diem

Trinity Health • Langhorne, PA

2d • Onsite

About The Position

The UM Registered Nurse is responsible for the coordinating and facilitating all aspects of reimbursement as related to the clinical review and level of care. Management of all review and appeals utilizing a modified approach based on specific needs of the patient population. Facilitates achievement of efficient resource consumption, and acceptable clinical outcomes, through integration and implementation of utilization management.
About us: St. Mary Medical Center is a beautiful 53-acre state-of-the-art facility comprised of more than 700 physicians, nearly 3,000 colleagues, and 1,100 volunteers committed to providing quality care delivered with compassion and respect. St. Mary attracts top doctors, introduces cutting-edge technologies and implements advanced procedures to meet the healthcare needs of the people it serves, including the nearly 630,000 residents of Bucks County.
Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.

Requirements

• Bachelor's degree in nursing required.
• Active PA RN License required.
• Previous experience in Utilization review required.
• Demonstrates ability to use problem solving, critical thinking, and priority setting skills.
• Must be able to work independently and on a team.
• Ability to perform diversified duties with time limitations with a high degree of accuracy

Nice To Haves

• CCM or Accredited Case Manager certification preferred.

Responsibilities

• coordinating and facilitating all aspects of reimbursement as related to the clinical review and level of care
• Management of all review and appeals utilizing a modified approach based on specific needs of the patient population.
• Facilitates achievement of efficient resource consumption, and acceptable clinical outcomes, through integration and implementation of utilization management

Benefits

• Work/Life balance with flexible schedules.
• Free onsite parking.
• Our mission and core values are what drive each member of Trinity Health to support each other, communicate openly and respectfully while embracing a culture that nurtures a healing, safe environment for all.
• Referral Rewards Program

What This Job Offers

• Job Type: Part-time