RN-Utilization Review Full Time

Baptist Memorial Health CareMemphis, TN
78d

About The Position

Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.

Requirements

  • RN with at least one (1) year of clinical experience

Nice To Haves

  • RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
  • BSN or MSN
  • Certified Case Manager
  • Knowledge of payer requirements

Responsibilities

  • Utilization Review
  • Discharge planning
  • Readmission Reduction Participation
  • Payer Communication and denial reduction
  • Completes assigned goals.

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What This Job Offers

Industry

Religious, Grantmaking, Civic, Professional, and Similar Organizations

Education Level

Associate degree

Number of Employees

5,001-10,000 employees

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