Utilization Management Coordinator/Registered Nurse - Full-Time/AM Shift
SIERRA VISTA HOSPITAL · Greater Sacramento · 2 mo ago
HealthcareFull-time
About the role
This position serves as a Utilization Management Coordinator/Registered Nurse within the Utilization Management Department at Sierra Vista Hospital. The role involves collaborating with medical staff, physicians, and other healthcare professionals to ensure efficient and effective utilization of healthcare resources.Responsibilities
- Evaluates medical necessity and appropriateness of services based on clinical guidelines and payer requirements.
- Communicates with providers regarding coverage decisions and appeals processes.
- Monitors and analyzes utilization data to identify trends and areas for improvement.
- Develops and implements strategies to optimize resource allocation and improve patient outcomes.
- Collaborates with interdisciplinary teams to develop and maintain policies and procedures related to utilization management.
Requirements
- Current Registered Nurse license in the state of Arizona.
- Bachelor's degree in Nursing or related field.
- Minimum of 2 years of experience in a healthcare setting, preferably in a utilization management role.
- Strong knowledge of healthcare regulations and reimbursement policies.
- Excellent communication and interpersonal skills.
- Proficiency in Microsoft Office Suite.
Qualifications
- Experience with electronic health records (EHR).
- Knowledge of healthcare coding and billing systems.
- Ability to work independently and manage multiple tasks simultaneously.
- Strong problem-solving and decision-making skills.
Skills
- Strong analytical and critical thinking skills.
- Effective written and verbal communication skills.
- Ability to prioritize tasks and meet deadlines.
- Attention to detail and accuracy in documentation.
Benefits
- Paid time off and holidays.
- Pension plan.
- Health, dental, and vision insurance.
- Flexible spending accounts (FSAs).
- Life insurance.