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Registered Nurse (RN) - Utilization Manager - Remote

Posted 4 days ago
All others
Full Time
USA

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.

O.C.F

Ochsner Clinic Foundation

Ochsner Clinic Foundation, established in 1942, is the leading not-for-profit healthcare provider in the Gulf South, dedicated to serving, healing, leading, educating, and innovating in patient care. With a workforce of over 36,000 employees and more than 4,600 physicians across 90 medical specialties, Ochsner operates 47 hospitals and over 370 health and urgent care centers throughout Louisiana, Mississippi, Alabama, and the Gulf South. Recognized for its commitment to quality and excellence, Ochsner has been named the No. 1 hospital in Louisiana for 12 consecutive years by U.S. News & World Report. The organization emphasizes a collaborative, physician-led environment that supports professional development and prioritizes diversity, equity, and inclusion. Ochsner Health is committed to empowering individuals to achieve better health outcomes and is recognized as a top workplace for its culture and values.

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