Registered Nurse - Utilization Review, Per Diem

Trinity Health • Philadelphia, PA

2d • Onsite

About The Position

The UM Registered Nurse is responsible for the coordinating and facilitating all aspects of reimbursement as related to the clinical review and level of care. Management of all review and appeals utilizing a modified approach based on specific needs of the patient population. Facilitates achievement of efficient resource consumption, and acceptable clinical outcomes, through integration and implementation of utilization management.

Requirements

• Bachelor's degree in nursing required.
• Active PA RN License required.
• Previous experience in Utilization review required.
• Demonstrates ability to use problem solving, critical thinking, and priority setting skills.
• Must be able to work independently and on a team.
• Ability to perform diversified duties with time limitations with a high degree of accuracy

Nice To Haves

• CCM or Accredited Case Manager certification preferred.

Responsibilities

• coordinating and facilitating all aspects of reimbursement as related to the clinical review and level of care
• Management of all review and appeals utilizing a modified approach based on specific needs of the patient population
• Facilitates achievement of efficient resource consumption, and acceptable clinical outcomes, through integration and implementation of utilization management

Benefits

• Work/Life balance with flexible schedules.
• Free onsite parking.
• Our mission and core values are what drive each member of Trinity Health to support each other, communicate openly and respectfully while embracing a culture that nurtures a healing, safe environment for all.
• Referral Rewards Program

What This Job Offers

• Job Type: Part-time