RN - Utilization Management
About the role
Experience the advantages of real career change. Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.
Responsibilities
The purpose of this position is to ensure that acute hospital admissions have the appropriate level of care, patient status, plan of care, and meet medical necessity for an acute hospitalization.
- Monitor that the patient is progressing in their plan of care and meets medical necessity for continued stay.
- Ensure the patient's payer has the clinical information to authorize an acute hospital stay and continued stay services, including covered days and associated services.
Requirements
- Graduate of an accredited nursing school
- Bachelor's Degree of Science in Nursing Required
- Master's degree Preferred
- 2 years of experience in an acute, post-acute, or payer setting Required
- 3 years of utilization review or care management experience Preferred
- RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required