RN - Utilization Management

Piedmont Healthcare•Atlanta, GA

About The Position

Experience the advantages of real career change. Join Piedmont to move your career in the right direction. Stay for the diverse teams you’ll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You’ll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.

Requirements

Graduate of an accredited nursing school
2 years of experience in an acute, post-acute or payer setting
RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure

Nice To Haves

Bachelor’s Degree of Science in Nursing
Master’s degree
3 years of utilization review or care management experience

Responsibilities

Ensure that acute hospital admissions have the appropriate level of care, patient status, plan of care, and meet medical necessity for an acute hospitalization.
Monitor that the patient is progressing in their plan of care and meet medical necessity for continued stay.
Ensure that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services.