RN Utilization Management Specialist
4 days ago
We are seeking a skilled RN Utilization Management Specialist to join our team at Riverside Health System. As a key member of our healthcare team, you will play a critical role in ensuring the judicious management of health system resources.
Key Responsibilities- Provide initial medical necessity reviews for patients hospitalized within the organization, adhering to national guidelines and standards of excellence.
- Contribute to decision-making and decision support as a member of the interdisciplinary team.
- Align practice with the organization's mission and vision, advancing the application of research and evidence-based practices.
- Maintain current knowledge of healthcare economics, trends, and reimbursement methodologies, and apply this knowledge to daily practice.
- Communicate effectively and professionally regarding modality, providing education to patients, families, and other members of the care team as needed.
- Program Graduate, Professional Nursing (Required)
- 3-4 years Clinical nursing experience (Required)
- Excellent verbal and written communication skills
- Excellent interpersonal skills
- Excellent organizational skills and attention to detail
- Ability to act with integrity, professionalism, and confidentiality
- Proficiency with computer systems required to perform job
- Registered Nurse (RN) - Virginia Department of Health Professions (VDHP) (Required)
- Certified Case Manager (CCM) - Commission for Case Manager Certification (Preferred) or Accredited Case Manager (ACM) - American Case Management Association (ACMA) (Preferred)
Riverside Health System is a leading healthcare provider in the region, dedicated to delivering high-quality patient care and advancing the health and well-being of our community.
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Newport News, Virginia, United States Riverside Health System Full timeAbout the RoleWe are seeking a skilled RN Utilization Management Specialist to join our team at Riverside Health System. This is a part-time position working 12-hour shifts in the Emergency Department at Riverside Regional Medical Center.Key ResponsibilitiesEnsure cost-effective patient care services are delivered by monitoring and reviewing documentation...
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