RN - Utilization Management, Weekends

Piedmont Healthcare • Atlanta, GA

3d

About The Position

The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures 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.

Requirements

• Degree from an accredited nursing school required, Bachelor of Science in Nursing preferred
• Two (2) years of experience in an acute, post-acute or payer setting
• Current unrestricted registered nurse (RN) license, in the state of Georgia

Nice To Haves

• Master's degree preferred and three years utilization review or Care Management experience

Responsibilities

• Ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization.
• Monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay.
• Ensures 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.

What This Job Offers

• Number of Employees: 5,001-10,000 employees