RN: Utilization & CDI Specialist

Meadville Medical Center; Meadville, Northern (Crawford County, KY); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Meadville Medical Center in Meadville, PA is seeking a qualified RN to support Utilization Management and clinical documentation efforts on-site. The role focuses on evaluating medical necessity, coordinating care, and ensuring accurate documentation.

External candidates may receive a $5,000 sign-on bonus. The position requires RN licensure, typically 5 years of experience, and collaboration with physicians, coding staff, and case managers to optimize patient care and reduce denials.

Qualifications

• Board-certified RN education/licensure required in the state.
• 5 years’ RN experience preferred.

Responsibilities

• Utilization management evaluation of medical necessity and appropriateness.
• Manage prior authorization and medical necessity reviews with payers.
• Collaborate with physicians, nursing staff, HIM/coding to optimize documentation and outcomes.
• Participate in rounding, case discussions, and education for staff and clinicians.

Skills

Utilization management

Clinical documentation

Interdisciplinary teamwork

Patient advocacy

Education

RN license

Job description

Meadville Medical Center in Meadville, PA is seeking a qualified RN to support Utilization Management and clinical documentation efforts on-site. The role focuses on evaluating medical necessity, coordinating care, and ensuring accurate documentation.

External candidates may receive a $5,000 sign-on bonus. The position requires RN licensure, typically 5 years of experience, and collaboration with physicians, coding staff, and case managers to optimize patient care and reduce denials.