Utilization Management Lead (RN/MSW/OT/PT)

Community LIFE; Pittsburgh (Allegheny County); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Vacation (5 weeks)

Paid Holidays

403(b) retirement plan

Tuition Reimbursement

Mileage Reimbursement

Employee Appreciation events

Job summary

Community LIFE Pittsburgh seeks an Utilization Management Coordinator (RN/ MSW/ OT/ PT) to coordinate utilization management across care levels. Based in Forest Hills, you will collaborate with RN Case Managers to ensure appropriate care transitions and clinical decisions.

The role requires PA licensure with relevant health care experience. You will work in a multi-disciplinary setting within a Day Center-based program, coordinating authorizations and ensuring compliance with policies and

Qualifications

• Bachelor degree in Nursing (BSN) or equivalent with RN licensure in Pennsylvania
• Masters of Social Work (MSW)
• Valid PA Driver’s license
• Minimum 3 years in utilization review and discharge planning

Responsibilities

• Perform/utilization management across levels of care
• Coordinate with RN Case Managers for care goals
• Support hospital & nursing facility service authorization processes
• Collaborate with interdisciplinary teams across settings
• Address post-acute care needs and transitions

Skills

Utilization management

Interdisciplinary teamwork

Microsoft Office

Clinical data interpretation

Outlook

Education

Bachelor degree in Nursing (BSN) or equivalent

Bachelor degree in Physical Therapy (PT)

Associate degree in Physical Therapy (PTA)

Bachelor degree in Occupational Therapy (OT)

Associate degree in Occupational Therapy Assistant (COTA/L)

Master of Social Work (MSW)

Tools

Outlook

Word

PowerPoint

Excel

Job description

Community LIFE Pittsburgh seeks an Utilization Management Coordinator (RN/ MSW/ OT/ PT) to coordinate utilization management across care levels. Based in Forest Hills, you will collaborate with RN Case Managers to ensure appropriate care transitions and clinical decisions.

The role requires PA licensure with relevant health care experience. You will work in a multi-disciplinary setting within a Day Center-based program, coordinating authorizations and ensuring compliance with policies and