Utilization Management RN – Hybrid & Acute Care

North Memorial Medical Center; Robbinsdale (MN); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Health insurance

401k Retirement Match or Pension Plan

Generous Paid Time Off (PTO) Plans

Adoption Reimbursement up to $3000 per

Child Care Discount Program with New

Education/Tuition Reimbursement

24/7 Fitness Center Access

Job summary

North Memorial Health is seeking an experienced Utilization Management RN to support medical staff at North Memorial Health and Maple Grove Hospital. You will assess admission necessity, aid in care coordination, and ensure quality outcomes through effective resource management.

This role requires RN licensure in MN, 3–5 years acute care and 1–2 years utilization review, with strong communication and conflict-resolution skills. Hybrid remote work eligible for MN/WI residents.

Qualifications

• Bachelor's degree in nursing required.
• 3–5 years of acute care nursing experience required.
• 1–2 years of utilization review experience preferred.
• One year of direct case management experience required.
• Hospital case management and utilization management experience required.
• Knowledge of Medicare rules and regulations.
• Strong communication skills with ability to express ideas clearly.
• Ability to deal with conflict in a positive manner.

Responsibilities

• Assess documented medical necessity to assist admission status.
• Provide clinically based information to support care coordination.
• Support quality clinical outcomes and resource management.
• Collaborate with nursing, social services, therapies, and other teams.
• Know disease trajectories, treatment plans, and length of stay.

Skills

Acute care nursing

Utilization review

Case management

Nursing theory

Medicare rules

Communication skills

Conflict resolution

Education

Bachelor's Degree in Nursing

Job description

North Memorial Health is seeking an experienced Utilization Management RN to support medical staff at North Memorial Health and Maple Grove Hospital. You will assess admission necessity, aid in care coordination, and ensure quality outcomes through effective resource management.

This role requires RN licensure in MN, 3–5 years acute care and 1–2 years utilization review, with strong communication and conflict-resolution skills. Hybrid remote work eligible for MN/WI residents.