Vacancy expired!
DescriptionDepartment: Utilization ReviewShift: DaysDaily Work Times: 8:00 a.m. - 4:30 p.m.Scheduled Biweekly Hours: 80Position Summary: In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on the regulatory and reimbursement requirements of various commercial and government payers. Partners with the health care team to ensure reimbursement of hospital admissions is based on medical necessity and documentation is sufficient to support the level of care being billed. Conducts concurrent reviews as directed in the hospital’s UR Plan of medical records to ensure criteria for admission and continued stay are met and documented. Along with other health care team members, monitors the use of hospital resources and identifies delays. Reports delays to leadership for resolution.QualificationsRequired
Nursing degree from an accredited educational institution
State of Michigan licensure as a Registered Nurse (RN)
Two years of recent clinical or utilization management experience
Preferred:
Bachelor’s degree in nursing.
Three years of recent case management or utilization management experience
Equal Opportunity Employerof Minorities/Females/Disabled/VeteransWe are committed toencouraging and sustaining a work environment free of unlawful harassment, discrimination,and/or retaliation. We are an Affirmative Action/Equal OpportunityEmployer committed to providing employment opportunity without regard to anindividual’s race, color, age, religion, sex/pregnancy (includingpregnancy/childbirth or pregnancy/childbirth-related conditions), sexualorientation, gender identity, national origin, disability, veteran status,genetic information, or any other status prohibited by applicable laws.We also make good faith efforts to recruit, hire, and promote qualified women,minorities, individuals with disabilities, and veterans.Job: NursePrimary Location: Michigan-Flint-McLaren Reg Med CenterEmployee Status RegularShift Day JobJob Type StandardSchedule Full-timeJob Posting Sep 16, 2019, 11:00:00 PMReq ID: 19009030
