Remote Utilization Management Specialist – MT RN/SW

Logan Health; Helena (MT); Remote; USD 52.000 - 75.000; Vollzeit

Benefits dieser Stelle

Four day work week

Affordable Medical Benefits package

401(k) with generous immediate match

Fitness Center Membership Discount

Mission-driven nursing culture

Zusammenfassung

Logan Health is seeking a Utilization Management Specialist to review admissions across our system and determine appropriate status. The role demands strong acute care experience, effective collaboration with physicians, case management, and insurance partners, and clear communication.

This full-time, remote-enabled position requires Montana residence, with four 10-hour shifts, weekend rotations, and holiday coverage.

Qualifikationen

• Current Montana RN License or multi-state compact license with MT authorization.
• Bachelor's degree in Social Work; associate degree required, Bachelor's preferred.
• Minimum five years’ acute care hospital experience.
• CCM Certification preferred; knowledge of Medicare/Medicaid UM regulations.

Aufgaben

• Review all daily inpatient and observation admissions across the Logan Health system.
• Evaluate physician documentation and patient data to determine admission status.
• Reassess patients to ensure continued criteria for level of care.
• Collaborate with physicians, case management and insurers to facilitate authorizations.
• Assist with peer-to-peer physician reviews and maintain documentation.

Kenntnisse

RN License

Communication skills

Analytical thinking

Interdisciplinary collaboration

Acute care experience

Ausbildung

Bachelor's degree in Social Work

Associate degree required

Bachelor's degree preferred

CCM Certification preferred

Jobbeschreibung

Logan Health is seeking a Utilization Management Specialist to review admissions across our system and determine appropriate status. The role demands strong acute care experience, effective collaboration with physicians, case management, and insurance partners, and clear communication.

This full-time, remote-enabled position requires Montana residence, with four 10-hour shifts, weekend rotations, and holiday coverage.