A company is looking for an Inpatient Utilization Management Clinician.
Key Responsibilities :
Perform utilization review activities for inpatient cases, applying evidence-based criteria
Monitor inpatient cases for compliance with regulations and facilitate discharge planning
Document and communicate all utilization review activities and outcomes effectively
Required Qualifications, Training, and Education :
Active, unrestricted RN license in state of residence
Nursing degree or diploma required; bachelor's degree in nursing preferred
2+ years of utilization review experience and knowledge of evidence-based guidelines
Experience in managed care and discharge planning
Knowledge of Medicare and Medicaid is desirable
Utilization Management Rn • Fremont, California, United States