Part-Time Utilization Management RN

Capital Health Screening Centre; Pennington (NJ); On-site; USD 54,000 - 70,000; Full time

Benefits offered by this job

Medical Plan

Dental Plan

Vision Plan

Paid Time-Off Program

Job summary

Capital Health seeks a registered nurse for Utilization Management to optimize patient care, length of stay, and resource use. The role requires five years of clinical nursing and three years in quality management or discharge planning.

You will review admissions, coordinate with payers, and guide care teams using MCG guidelines and UR software. Responsibilities include chart reviews, admission determinations, and ongoing collaboration with physicians to ensure appropriate level of care.

Qualifications

• Associate's degree in nursing required.
• NJ RN license required; CPHQ/CCM/CPUR preferred.
• 5 years' clinical nursing and 3 years in QA/utilization review or discharge planning.
• Knowledge of MCG guidelines; UR software familiarity.
• Strong computer and data analysis skills.

Responsibilities

• Perform chart reviews to assess quality, timeliness, and appropriateness of care.
• Conduct admission reviews for Medicare/Medicaid and other payers.
• Perform concurrent and retrospective reviews to reduce length of stay and resource use.
• Collaborate with physicians and care teams to resolve progression of care barriers.
• Promote evidence-based protocols and participate in performance improvement.
• Maintain documentation in Utilization software and attend care conferences.

Skills

Nursing experience

Quality management

Utilization review

Discharge planning

UR software

Education

Associate's degree in nursing

NJ RN license

CPHQ/CCM/CPUR preferred

Tools

Microsoft Office

EMR systems

Utilization management software

Job description

Capital Health seeks a registered nurse for Utilization Management to optimize patient care, length of stay, and resource use. The role requires five years of clinical nursing and three years in quality management or discharge planning.

You will review admissions, coordinate with payers, and guide care teams using MCG guidelines and UR software. Responsibilities include chart reviews, admission determinations, and ongoing collaboration with physicians to ensure appropriate level of care.