RN - Utilization Management

Piedmont; Atlanta (GA); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Job summary

Piedmont Healthcare Corporate is seeking an RN to ensure appropriate level of care for acute hospital admissions, monitor patient progress, and support ongoing authorization with payers. The role requires licensure in Georgia and experience in acute, post-acute, or payer settings.

A BSN is preferred, and a master's degree is a plus. Two years of relevant experience are expected, with utilization review or care management experience valued.

Qualifications

• 2 years of experience in an acute, post-acute or payer setting required.
• 3 years of utilization review or care management experience preferred.
• RN - Georgia licensure required.

Responsibilities

• The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization.
• This role monitors patient progress in the plan of care and ensures payer information supports authorization for continued stay and related services.

Skills

Acute care experience

Utilization review, care management

RN licensure Georgia

Education

Graduate of an accredited nursing school

Bachelor's Degree of Science in Nursing

Master's degree

Job description

Overview

Experience the advantages of real career change

Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.

Responsibilities

The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services.

Qualifications

Education

• Graduate of an accredited nursing school Required
• Bachelor's Degree of Science in Nursing Preferred
• Master's degree Preferred

Work Experience

• 2 years of experience in an acute, post-acute or payer setting Required
• 3 years of utilization review or care management experience Preferred

Licenses and Certifications

• RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required

Business Unit : Company Name:
Piedmont Healthcare Corporate