Healthcare Utilization Specialist

5 days ago


St Louis, Missouri, United States BJC HealthCare Full time

About Us

BJC HealthCare is a leading nonprofit healthcare organization in the United States, delivering high-quality services to residents across various communities. With over 30,000 employees and 14 hospitals, BJC serves patients through its comprehensive range of services including inpatient and outpatient care, primary care, community health, and more.

We are committed to providing exceptional patient care and ensuring that our services are accessible to all, regardless of their ability to pay. Our community benefits program provides significant financial assistance to patients, totaling millions annually.

Job Description

The Clinical Resource Facilitator RN will serve as a clinical resource and subject matter expert to the care coordination department. This role will focus on level of care/medical necessity, progression of care, and care transition processes. The successful candidate will work closely with department management to ensure the highest quality of care coordination.

Key Responsibilities

  • Cover UM assignments when there are staffing gaps due to scheduled vacations or staff outages
  • Help onboard and train new hires
  • Assess learning opportunities among the staff and conduct individual and/or team education in meetings

Requirements

  • Nursing Diploma/Associate's - Nursing
  • Bachelor's Degree - Nursing

Benefits

At BJC HealthCare, we offer a comprehensive benefits package that includes medical, dental, vision, life insurance, and legal services. We also provide disability insurance, a pension plan, and flexible spending accounts for healthcare and dependent care.



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