UR RN Manager - Strategic Utilization Leadership

Yuma Regional Medical Center; Yuma (AZ); On-site; USD 100,000 - 161,000; Full time

Job summary

Yuma Regional Medical Center is seeking a UR RN Manager to lead the hospital's Utilization Review program under the Director of Care Management. You will ensure medical necessity reviews, proper level of care determinations, and compliant documentation to support appropriate patient status and reimbursement.

You will supervise UR Nurses and Denials staff, drive performance improvement, collaborate with Revenue Cycle, CDI, Quality and physician leadership, and mentor staff to meet regulatory and

Qualifications

• 3+ years related experience in hospital utilization management.
• Bachelor's Degree in Nursing required.
• AZ RN License and BLS certification required.

Responsibilities

• Provides leadership, oversight, and daily operational management for the Utilization Management Department.
• Ensures accurate admission status determinations, medical necessity reviews, and denial prevention.
• Collaborates with Revenue Cycle, CDI, Quality, and physician leadership to optimize reimbursement and compliance.
• Develops staff through coaching, onboarding, and competency validation.
• Monitors KPIs and leads performance improvement initiatives in utilization management.

Education

Bachelor's Degree in Nursing

AZ RN License

BLS Certification

Job description

Yuma Regional Medical Center is seeking a UR RN Manager to lead the hospital's Utilization Review program under the Director of Care Management. You will ensure medical necessity reviews, proper level of care determinations, and compliant documentation to support appropriate patient status and reimbursement.

You will supervise UR Nurses and Denials staff, drive performance improvement, collaborate with Revenue Cycle, CDI, Quality and physician leadership, and mentor staff to meet regulatory and