Utilization Review RN

UPMC International; Steubenville (OH); On-site; USD 55,000 - 85,000; Full time

Job summary

UPMC is seeking a case management professional to oversee utilization review, resource management, and coordination of the continuum of care within the hospital setting. The role emphasizes ensuring appropriate discharge planning and quality patient care through collaboration with the care team.

Responsibilities include assessing clinical needs, optimizing discharge planning, and maintaining thorough clinical documentation. Additional related duties may be assigned as needed.

Qualifications

• Utilization Review: assess and manage resource use to ensure high-quality, cost-efficient care.
• Resource management and discharge planning across the continuum of care.
• Clinical documentation management and coordinated care collaboration.

Responsibilities

• Utilization Review: manages consumption of resources ensuring services are patient focused, high quality, efficient and cost-effective.
• Managing the Continuum of Care through assessment of clinical needs and discharge planning.
• Performs other related duties as assigned.

Job description

Purpose:

Performs the four key functions of case management: Utilization review, Resource management, Managing thecontinuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay andreimbursement for all hospital admissions. Promotes quality care through collaboration with all team members.

Responsibilities:

• Utilization ReviewManages consumption of resources ensuring services are patient focused, high quality, efficient and costeffective.Managing the Continuum of Care through assessment of clinical needs and discharge planning.Performs other related duties as assigned