Utilization Review Registered Nurse, PRN

Trinity Health; Georgia; On-site; USD 34,000 - 48,000; Part time

Job summary

Trinity Health in Georgia is seeking a part-time Utilization Review Coordinator to support patient care across the hospital continuum. You will collaborate with physicians, nurses, and billing staff to ensure appropriate care levels and efficient resource use.

The role requires conducting clinical reviews using medical necessity criteria and serving as a liaison with external payers on authorization requirements and timely service utilization.

Responsibilities

• Collaborates with physicians, nurses, patient access staff, billing personnel, and external payers to ensure appropriate level of care and efficient resource utilization throughout hospitalization.
• Acts as liaison between the hospital and external payers regarding medical necessity, authorization requirements, and timely utilization of hospital services.

Job description

Employment Type: Part time Shift:

Description

Position Summary: The Utilization Review (UR) Coordinator collaborates with a multidisciplinary team, including physicians, nurses, patient access staff, billing personnel, and external payers, to ensure patients receive the appropriate level of care throughout the continuum of care in an efficient, cost-effective, and quality-focused manner. The UR Coordinator conducts clinical reviews using established medical necessity criteria to support accurate patient status determinations and appropriate resource utilization throughout hospitalization. This role serves as a liaison between the hospital and external payers regarding medical necessity, severity of illness, intensity of service, authorization requirements, and timely utilization of hospital services.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.