Specialist (Part-time) - Utilization Management

About the role

Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally accepted and evidence-based criteria to certify an admission to the facility, and for concurrent/continued stay review as appropriate. Also responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management.

Responsibilities

• Review clinical documentation in the EMR.
• Compare documentation to nationally accepted, evidence-based admission criteria.
• Certify admissions based on criteria.
• Perform concurrent/continued stay reviews as appropriate.
• Maintain compliance with CMS Conditions of Participation for Utilization Management.

Requirements

• Bachelor's Degree in Nursing or Master's Degree in Nursing required.
• Three (3) years advanced clinical experience in a hospital setting required.
• Current RN license in state of employment or multistate RN license via Nurse Licensure Compact.

Skills

• Financial Counseling experience preferred.

Benefits

• 75% Penn State tuition discount for employees and eligible dependents via Grant-in-Aid program.
• Medical, dental, and vision coverage with no waiting period.
• Total Rewards Program including employee wellness programs, fitness discounts (University Fitness Center, Peloton).
• Generous paid time off, personal time, and paid parental leave.
• Retirement, extended illness bank, life insurance, identity theft protection.
• Competitive pay, tuition reimbursement, PAWS UP employee recognition program.
• HR Solution Center support, learning and organizational development, virtual benefits orientation, employee exclusive concierge service.

Schedule

Part‑time (0.50 FTE) weekend shift: 7:30 a.m. – 5:30 p.m.