Utilization Review RN

UPMC • Steubenville, OH

8h

About The Position

Performs the four key functions of case management: utilization review, resource management, managing the continuum of care, and clinical documentation management. The role is responsible for facilitating appropriate length of stay and reimbursement for all hospital admissions and promotes quality care through collaboration with all team members.

Requirements

• Registered Nurse.
• Ohio nursing license.
• Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR).
• Current licensure in the state where the facility is located, or a multistate license issued by a participating Nursing Licensure Compact (NLC) state when applicable. Employees working on an out-of-state NLC license who change their residency to the facility's state must apply for licensure in that state within 60 days.
• Ability to assess medical necessity and progress through chart review.
• Computer literacy, including operation of computers and software applications.

Nice To Haves

• Three years of clinical nursing experience in an acute care setting.
• Certification in Case Management.
• Experience in utilization review, discharge planning, case management, or quality improvement.

Responsibilities

• Manage consumption of resources to ensure services are patient-focused, high-quality, efficient, and cost-effective.
• Manage the continuum of care through assessment of clinical needs and discharge planning.
• Perform other related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed