G
Utilization Review Registered Nurse, PRN
Utilization Review Registered Nurse, PRN is an open position at GA_SMHHS St. Mary's Hospital in St. Mary's Health Care System, GA. This is a PRN / per diem role. Apply directly through the employer below, or browse similar roles.
Employment Type:
Part timeShift:
Description:
Position Summary: The Utilization Review (UR) Coordinator collaborates with a multidisciplinary team, including physicians, nurses, patient access staff, billing personnel, and external payers, to ensure patients receive the appropriate level of care throughout the continuum of care in an efficient, cost-effective, and quality-focused manner. The UR Coordinator conducts clinical reviews using established medical necessity criteria to support accurate patient status determinations and appropriate resource utilization throughout hospitalization. This role serves as a liaison between the hospital and external payers regarding medical necessity, severity of illness, intensity of service, authorization requirements, and timely utilization of hospital services.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Similar jobs
- Emergency Medical Technician ( EMT ) - FT - 8pm-8am - Waterbury at CT_THOfNE01 Trinity Health Of New England Corporation — Saint Mary's Hospital Waterbury, CT
- Medical Assistant - Neurosurgery at CT_THOfNE01 Trinity Health Of New England Corporation — NESF - Hartford, CT
- Nurse Practitioner or Physician Assistant, Endocrine Specialists at GA_SMHHS03 St. Mary's Medical Group — St. Mary's Health Care System, GA
- Senior Registered Nurse (RN) - Cardiac Imaging - PD at NY_SPHP01 St. Peter's Hospital — Albany Associates in Cardiology - Albany, NY
- Local Contract Registered Nurse, RN, Med/Surg Tele at Trinity Health — Saint Joseph Mercy Health System Hospita
- Local Contract, Registered Nurse, RN, Med/Surg Tele at Trinity Health — Saint Joseph Mercy Health System Hospita