RN-Utilization Review

Baptist Memorial Health CareMemphis, TN
64d

About The Position

The position involves managing the care for a specific population, ensuring a safe transition of patients throughout the continuum of care. This includes appropriate utilization of resources, service delivery, and compliance with federal and other payer requirements. The role requires early assessment of transitional needs identified during hospitalization, illness, or life situations. Additional duties may be assigned as necessary.

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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