RN Utilization & Discharge Navigator

St. Tammany Parish Hospital; Wheeler Heights (OR); On-site; USD 85,000 - 110,000; Full time

Job summary

St. Tammany Health System seeks an Utilization Manager to assist in planning, coordinating, and administering Utilization Management activities.

Responsibilities include daily chart reviews for medical necessity, coordinating admissions and discharges, and supporting the Department Head. Minimum qualifications include an accredited nursing degree with active RN licensure, at least five years in hospital nursing, and preferred experience in Utilization Management and DRG/CPT-ICD-9 knowledge.

Qualifications

• Graduate of accredited nursing program with active RN license.
• 5 years hospital nursing experience preferred.
• Experience in Utilization Management preferred.
• Knowledge of CPT-ICD-9 coding and DRG management preferred.

Responsibilities

• Daily review of medical records to assess appropriateness and medical necessity.
• Coordinate admission, continued stay, resource use, and discharge readiness.
• Maintain confidentiality of all information and assist department head.

Skills

RN/Licensed Nurse

Utilization Management

CPT-ICD-9 coding

DRG management

Communication skills

Education

Registered Nurse degree

Tools

CPT-ICD-9 coding principles

DRG management

Job description

St. Tammany Health System seeks an Utilization Manager to assist in planning, coordinating, and administering Utilization Management activities.

Responsibilities include daily chart reviews for medical necessity, coordinating admissions and discharges, and supporting the Department Head. Minimum qualifications include an accredited nursing degree with active RN licensure, at least five years in hospital nursing, and preferred experience in Utilization Management and DRG/CPT-ICD-9 knowledge.