Night RN Utilization Review Coordinator (Remote)

Trinity Health; Grand Rapids (MI); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Remote work

Job summary

Trinity Health is seeking a Night Shift RN Utilization Review in Grand Rapids, MI, offering full-time work with remote options. You will review assigned cases against criteria and payor guidelines to ensure proper reimbursement and medical necessity for acute care hospitalization.

In collaboration with the health care team, you will conduct observation, admission, concurrent, discharge, and retrospective reviews to evaluate level of care and discharge planning, and you will provide consultation

Qualifications

• Bachelor of Science in Nursing (BSN) required.
• Current State of Michigan Registered Nurse License.
• Three years acute care as an RN.
• Preferred: Two years acute care utilization management experience; facility audits and processes.

Responsibilities

• Perform all aspects of utilization review to ensure medical necessity with supportive documentation in the EMR.
• Provide external review organizations the information necessary to complete reviews and maximize reimbursement.
• Collaborate with Case Management.
• Provide consultation and information to physicians, case managers and other health care team members.

Education

BSN

Job description

Trinity Health is seeking a Night Shift RN Utilization Review in Grand Rapids, MI, offering full-time work with remote options. You will review assigned cases against criteria and payor guidelines to ensure proper reimbursement and medical necessity for acute care hospitalization.

In collaboration with the health care team, you will conduct observation, admission, concurrent, discharge, and retrospective reviews to evaluate level of care and discharge planning, and you will provide consultation