Case Manager - Utilization Management

Responsibilities

• Ensures appropriate use of hospital resources by reviewing patients admitted to the hospital
• Provides timely, accurate, and thorough clinical reviews
• Develops and implements methods, policies, and procedures to improve departmental efficiency
• Works collaboratively with management and peers to facilitate appropriate patient class assignment

Requirements

• Specialized Diploma in nursing
• 2 years of previous utilization review experience
• Knowledge of utilization management as it relates to third party payers
• Ability to maintain strict adherence to HIPAA
• Ability to work in a team environment
• Ability to be attentive to detail
• RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire