RN Utilization Manager - Remote

Overview

The RN Utilization Manager at Ochsner Health is responsible for managing patient care processes and ensuring compliance with medical necessity criteria while serving as a liaison among patients, caregivers, and healthcare teams.

In Short

• Manage pre-admission, admission, and continued stay activities.
• Communicate effectively with multidisciplinary teams and third-party payers.
• Ensure compliance with healthcare regulations and standards.
• Utilize knowledge of healthcare delivery systems to optimize patient care.
• Document reviews and care options in the hospital approved data set.
• Maintain open communication with all relevant parties.
• Respond positively to changes in a high-pressure environment.
• Support the values of service excellence and teamwork.
• Work independently while also collaborating within a team.
• Participate in professional development and maintain licensure.

Requirements

• Registered Nurse Diploma or equivalent.
• 1 year of hospital-based experience in patient care.
• Experience in case management or utilization review preferred.
• Current RN license in the state of practice required.
• Proficient in Windows-style applications and data entry.
• Effective verbal and written communication skills.
• Strong conflict resolution skills.
• Ability to work calmly and efficiently under pressure.
• Strong ethical principles and professionalism.
• Willingness to work a flexible schedule.

Benefits

• Opportunity to make a difference in patient care.
• Supportive work environment focused on professional development.
• Access to a wide range of healthcare services.
• Involvement in a recognized healthcare organization.
• Comprehensive employee benefits package.
• Recognition as a top workplace for diversity and culture.
• Access to ongoing training and education.
• Engagement in community health initiatives.
• Flexible work arrangements.
• Participation in a strong team-oriented culture.