Utilization Manager - PRN (2 Shifts/Month)

Duke Careers; Durham (NC); On-site; USD 78,000 - 102,000; Part time

Job summary

Duke University Health System is seeking a Utilization Manager, PRN, to support 2 shifts of 8 hours per month in Durham, NC. You will validate authorizations, manage concurrent cases, perform initial and ongoing medical necessity reviews, and work with physicians and the care team to ensure timely, appropriate care.

This role requires a BSN, at least three years of acute clinical practice, and Case Management Certification within two years of hire.

Qualifications

• BSN required.
• Minimum of three years recent acute clinical practice.
• Case Management Certification within 2 years of hire.
• Current RN licensure in North Carolina.

Responsibilities

• Validate authorization for bedded patients and payer authorization within time frames.
• Manage concurrent cases to ensure medical necessity.
• Conduct initial and ongoing reviews per UM plan.
• Collaborate with physicians and care team to verify information.
• Communicate estimated LOS and discharge date using GMLOS.
• Support discharge planning and resource utilization.

Skills

Basic computer proficiency

EHR navigation

Self-directed work style

Problem solving

Written and verbal communication

Education

BSN degree

RN licensure NC

Case Management Certification within 2 years

Tools

Microsoft Word

Excel

PowerPoint

Job description

Duke University Health System is seeking a Utilization Manager, PRN, to support 2 shifts of 8 hours per month in Durham, NC. You will validate authorizations, manage concurrent cases, perform initial and ongoing medical necessity reviews, and work with physicians and the care team to ensure timely, appropriate care.

This role requires a BSN, at least three years of acute clinical practice, and Case Management Certification within two years of hire.