Case Manager/ Utilization Review RN, FT days- REMOTE

Company: St. Mary's Health Care System
Location: Athens
Posted on: March 9, 2025

Job Description:

Employment Type:Full timeShift:Day ShiftDescription:Will work some weekends

The Utilization Review (UR) Coordinator works, in collaboration with a multidisciplinary team that includes, but is not limited to, physicians, nurses, patient access, and billing staff, along with external insurance payers, to ensure patients progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes. UR Coordinator utilizes established guidelines to support appropriate level of care throughout hospitalization and serves as a liaison between the hospital and external payers on issues related to severity of illness and intensity of service for patients to ensure appropriate and timely utilization of hospital services.Licensure/Certification/Registration: Current GA RN license. BLS required - must be obtained within initial 90-days of employment.Education: Must be a graduate of an accredited school of nursing, BSN recommended.Experience: Must have a minimum of 3-5 years experience in nursing, preferably in a hospital setting and a minimum of 1 year in case management, utilization management, or discharge planning preferred for RN. Certification in case management preferred.Special Qualifications: Excellent communication, interpersonal, and critical thinking skills.Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law. Associated topics: cardiothoracic, infusion, intensive, intensive care, nurse rn, psychatric, psychiatric, registered nurse, surgery, unit

Keywords: St. Mary's Health Care System, Athens , Case Manager/ Utilization Review RN, FT days- REMOTE, Executive , Athens, Georgia