Per Diem Utilization Review RN

Capital Health (US); Pennington (NJ); On-site; USD 5,428,000 - 7,091,000; Part time

Benefits offered by this job

Retirement Savings and Investment Plan

Disability Benefits – Short Term

Sick Time Off

Employee Assistance Program

Job summary

Capital Health is seeking a per diem Utilization Management Nurse to support quality, clinical and cost-effective outcomes. You will review patient care plans, communicate with payers, and collaborate with the health care team to optimize length of stay and resource use without compromising care.

The role requires an Associate's degree in nursing, five years of clinical nursing and three years in quality management or discharge planning, NJ RN licensure, and familiarity with UR software and EMR

Qualifications

• Associate degree in nursing required.
• Five years' clinical nursing experience and three years in quality management or discharge planning.
• NJ RN license; CPHQ/CCM/CPUR preferred.

Responsibilities

• Performs chart review to evaluate quality, timeliness and appropriateness of care.
• Conducts admission reviews for Medicare/Medicaid and other payers to determine level of care.
• Gathers data for continued stay utilization reviews and workflow with payers and UR physician advisor.

Skills

Clinical nursing

Quality management

Utilization review

Problem solving

Microsoft Office

Education

Associate's degree in nursing

Tools

UR software

EMR

MCG guidelines

Job description

Capital Health is seeking a per diem Utilization Management Nurse to support quality, clinical and cost-effective outcomes. You will review patient care plans, communicate with payers, and collaborate with the health care team to optimize length of stay and resource use without compromising care.

The role requires an Associate's degree in nursing, five years of clinical nursing and three years in quality management or discharge planning, NJ RN licensure, and familiarity with UR software and EMR