RN Utilization Review Specialist PRN

Corewell Health; Caledonia (MI); On-site; USD 41,328 - 55,104; Part time

Benefits offered by this job

Comprehensive benefits package

On-demand pay program

Discounts on restaurants and services

Optional insurance plans

Retirement options with match savings

Job summary

A regional healthcare provider is seeking a part-time RN Utilization Review Specialist in Caledonia, Michigan. The role involves assessing inpatient admissions, advocating for patients within acute care services, and educating medical staff on utilization management. Ideal candidates must have an Associate's Degree in Nursing, relevant experience, and a valid Michigan RN license. Comprehensive benefits and work-life balance initiatives are offered as part of this position.

Qualifications

• Minimum 2 years of relevant experience in acute care, clinical nursing, or related experience.
• Active Registered Nurse (RN) license in the State of Michigan is required.

Responsibilities

• Provides health information and acts as a resource for nursing units.
• Assesses appropriateness of inpatient admissions and continued stay.
• Educates medical staff regarding utilization management and quality requirements.

Skills

Clinical nursing

Utilization management

Interpersonal communication

Quality improvement

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Registered Nurse (RN) – State of Michigan

Job description

RN Utilization Review Specialist PRN

Corewell Health

Location: 4700 60th St – Grand Rapids, MI

Employment Type: Part time

Shift: Day (United States of America)

Hours of Work: 8:00 a.m. to 4:30 p.m.

Job Responsibilities

• Provides health information, interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate use of acute care services and diagnosis-related group (DRG) management.
• Assesses appropriateness of inpatient admissions and continued stay.
• Educates medical staff and other health care professionals regarding utilization management and quality requirements.
• Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization.
• Works closely with inpatient care facilitators and Medical Social Workers to move patients through the continuum appropriately.
• Adjusts patient registration status code as needed to maximize reimbursement and be consistent with regulatory standards.
• Communicates with physicians, medical social workers, and other hospital personnel concerning change in level of care on the medically complex patient population; makes recommendations and discusses alternatives.
• Documents instances where services were delayed, inappropriate, refused, complicated, etc. for resource management functions.
• Identifies quality indicators to facilitate process improvement and physician education.

Qualifications

• Associate's Degree in Nursing (required)
• Bachelor's Degree in Nursing (preferred)
• Minimum 2 years of relevant experience acute care, clinical nursing, preferably multiple clinical settings, or related experience (required)
• Registered Nurse (RN) – State of Michigan required

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv.
• Discounts directory with deals on restaurants, phone plans, spas, and more.
• Optional identity theft protection, home and auto insurance, pet insurance.
• Traditional and Roth retirement options with service contribution and match savings.
• Eligibility for benefits is determined by employment type and status.

EEO Statement

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with vaccine requirements. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

You may request assistance in completing the application process by calling 616.486.7447.