Registered Nurse (RN) - Utilization Manager - Remote

Overview

The Registered Nurse (RN) - Utilization Manager is responsible for managing patient care and ensuring that appropriate medical necessity criteria are applied for hospital admissions and continued stays. The role involves collaboration with physicians, patients, caregivers, and third-party payers to facilitate effective healthcare delivery.

In Short

• Manage patient care through the healthcare system.
• Conduct pre-admission, admission, and continued stay activities.
• Communicate effectively with medical staff and patients.
• Document reviews and care plans in hospital systems.
• Interact with managed care and third-party payers.
• Work independently and as part of a team.
• Respond to changes and work calmly under pressure.
• Maintain compliance with healthcare regulations.
• Participate in professional development activities.
• Support the values of service excellence and integrity.

Requirements

• Current Registered Nurse License in Louisiana.
• 1 year of hospital-based experience in patient care.
• Experience in case management or utilization review preferred.
• Strong communication and conflict resolution skills.
• Proficient in computer skills and data entry.
• Ability to work in high-pressure situations.
• Strong ethical principles and professionalism.
• Flexibility to work various shifts including weekends.
• Ability to lift and move patients and objects as required.
• Knowledge of healthcare delivery systems.

Benefits

• Opportunity to make a difference in patient care.
• Supportive work environment.
• Professional development opportunities.
• Competitive salary and benefits package.
• Recognition as a top workplace in healthcare.
• Access to advanced healthcare resources.
• Commitment to diversity and inclusion.
• Participation in community health initiatives.
• Flexible scheduling options.
• Work with a dedicated team of healthcare professionals.