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Hospital Utilization Management RN
1 month ago
A well-established hospital in the California Central Valley is actively searching for a Utilization Management RN to join their team.
This 150+ bed short-term acute care hospital has proudly provided care to San Joaquin Valley residents for over half a century. Medical services include 24-hour Emergency Services, OB Services, Pediatrics, Physical Therapy, Orthopedics, and Mental Health Services. This hospital has achieved TJC The Joint Commission Gold Seal of Approval and is a Baby-Friendly Designated Hospital.
The Utilization Management RN will play a vital role in assuring proper utilization of hospital resources for Medicare, Medi-Cal, Managed Care Plans, and other third-party payers. The Utilization Management RN is responsible for overseeing the utilization management process and will lead a team of professionals in reviewing healthcare services, ensuring their medical necessity and appropriateness while complying with regulations and industry standards. This role involves following policies and procedures, monitoring compliance, and analyzing data to improve processes. The Utilization Management Nurse will also communicate with healthcare providers and insurance companies, advocate for patients' rights, and drive continuous improvement initiatives.
The Utilization Management RN will enjoy this area of Central California for its easy access to outdoor recreation with proximity to National Parks and National Forests, in addition to its friendly community atmosphere and affordable housing options.
Take this opportunity to apply your experience as a Utilization Management RN . This position offers competitive compensation and generous benefits. Submit your resume and connect with a recruiter to learn more about this opportunity.
