Utilization Manager

4 weeks ago


Hendersonville, North Carolina, United States UNC Health Care Full time
Job Summary

We are seeking a highly skilled Utilization Manager to join our team at UNC Health Care. As a key member of our Acute Care Case Management team, you will play a critical role in ensuring the optimal care and utilization of our patients.

Key Responsibilities
  • Conduct thorough admission reviews and continued stay reviews to ensure medical necessity and appropriateness of care.
  • Collaborate with interdisciplinary teams to coordinate patient care and ensure timely and accurate documentation.
  • Communicate daily with Care Managers to manage level of care transitions and utilization of services.
  • Coordinate with payers to ensure pre-certification and re-certifications as required.
  • Identify high-risk patients and facilitate referrals to social work and other care management services.
Requirements
  • Current licensure as a Registered Nurse in the state of North Carolina or a compact state.
  • Two years of experience working as a Registered Nurse.
  • Strong verbal and written communication skills.
  • Basic Life Support (BLS) certification.
Preferred Qualifications
  • Bachelor's of Science in Nursing (BSN).
  • Certification in Case Management.
About UNC Health Care

UNC Health Care is a leading healthcare provider in the region, dedicated to improving the health and well-being of our patients and communities. We offer a dynamic and supportive work environment, with opportunities for professional growth and development.



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