Utilization Management RN: Care Coordination Pro

Bryan Health; Lincoln (NE); On-site; USD 75,000 - 110,000; Full time

Job summary

Bryan Health is seeking an experienced registered nurse to lead utilization coordination for hospital stays. You will ensure medical necessity and obtain payer authorizations while supporting the patient’s journey and hospital finances.

Collaborate with physicians, discharge planners, and care teams to optimize length of stay and resource use, while maintaining high-quality patient care. Nebraska RN licensure and BLS are required, with 2 years of clinical experience preferred.

Qualifications

• Nebraska RN license or compact state license required.
• Two years of recent clinical experience required.
• BLS certification required.

Responsibilities

• Perform utilization review activities (concurrent/retrospective).
• Assess medical necessity using evidence-based guidelines.
• Collaborate with care team to manage length of stay and continuing medical necessity.
• Participate in denial/appeals process and pursue appropriate documentation.
• Serve as a resource on appropriate level of care and payer rules.
• Promote quality improvement and cost-effective care.

Skills

Clinical competency

Payer regulations knowledge

Computer literacy

Conflict resolution

Verbal & written communication

Crucial conversations

Interprofessional collaboration

Critical thinking

Confidentiality

Time management

Attendance reliability

Education

RN licensure (Nebraska or compact state)

Tools

EHR systems

Job description

Bryan Health is seeking an experienced registered nurse to lead utilization coordination for hospital stays. You will ensure medical necessity and obtain payer authorizations while supporting the patient’s journey and hospital finances.

Collaborate with physicians, discharge planners, and care teams to optimize length of stay and resource use, while maintaining high-quality patient care. Nebraska RN licensure and BLS are required, with 2 years of clinical experience preferred.