About The Position

The Utilization Management Nurse (UM RN) collaborates with members of the healthcare team to ensure optimum delivery of services across the healthcare continuum. The UM RN partners with interdisciplinary teams to improve delivery of patient care through monitoring of healthcare resources for effective and efficient utilization. The UM RN serves as internal consultant to healthcare team members by providing education relevant to clinical, financial and resource outcomes.

Requirements

  • Baccalaureate degree in Nursing; if candidate does not possess a Baccalaureate in Nursing, then a graduate degree in Nursing is required
  • Registered Nurse licensed in state of Missouri, BSN preferred
  • 2 years clinical experience in acute hospital setting
  • Proficient in the use of window-based computer programs
  • Excellent verbal, written, and interpersonal communication skills
  • Ability to work within a fast-paced team-oriented environment
  • Critical thinking skills, creative problem solving, and proficient organization and planning skills

Nice To Haves

  • Utilization Management experience
  • Experience with managed care, performance improvement, TJC, and CMS standards
  • Nationally recognized certification applicable to UM/CM
  • Knowledge of ICD / CPT / DRG’s
  • Experience with analyzing data/statistical information

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

1,001-5,000 employees

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