RN-Utilization Review- 40/hrs, Day Shifts (Temple Hospital)

Temple University Health System • Philadelphia, PA

2d • Onsite

About The Position

Temple University Hospital is a nationally respected teaching hospital on Temple University's Health Sciences Center campus, providing a comprehensive array of healthcare services. It serves as the chief clinical training site for the Lewis Katz School of Medicine at Temple University, fostering an environment for high-quality care, teaching, and research. Temple Health is a dynamic network of hospitals, specialty centers, and physician practices dedicated to advancing disease fight, medical science, and healthcare education. The network includes Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team, all affiliated with the Lewis Katz School of Medicine at Temple University. Temple Health employs a diverse workforce of 10,000 individuals committed to creating a healthy, safe, and productive environment. The hospital is an Equal Opportunity Employer, committed to diversity and non-discrimination.

Requirements

• Graduate of an accredited school of nursing
• BSN Required
• 1 year experience of recent Utilization Review in acute care or in insurance company setting.
• 1 year experience in medical-surgical setting.
• 1 year experience in working with competency utilizing InterQual criteria.
• General Experience in working with utilization review standards
• PA Registered Nurse License Required
• Multi State Compact RN License Required

Nice To Haves

• Certified Case Manager Preferred

Responsibilities

• Utilizing InterQual and other appropriate criteria, responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospital's utilization management and quality assurance plan.
• Will determine the medical necessity for admission and continued stays for patients within department's scope of service and to meet the hospital's objectives for assuring a high quality of patient care as well as assuring the effective and efficient utilization of available health services.
• Identifies appropriate level of care for inpatients and outpatients requiring overnight care.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level