Utilization Management Nurse

Focused on the Future of Care

We're looking for talented, passionate healthcare professionals to join the team at Memorial Health as we build the future of healthcare. If you're ready to be part of a transformative organization that puts people first, take a look at what we have to offer.

Position Type:

On-site

Job Description Summary:

Performs clinical review of patient records to evaluate the utilization of acute care services. Communicates to third party payors to support the medical necessity of the hospital admission for services reimbursement. Ensures the patient care team is aware of general length of stay requirements for all patients. Facilitates physician documentation through concurrent interaction with physicians to support reimbursement and clinical severity is captured for the service rendered to patients receiving hospital care. Provides clinical knowledge and data collection for quality improvement initiatives. Optimizes reimbursement for acute care services.

Job Description:

Schedule: 12:00pm - 12:00am, onsite

Pay Transparency

$32.95 - $52.73

Additional compensation in the form(s) of participation in our annual incentive program are dependent on role. Pay is based on factors such as work experience, education, certification(s), training, skills, and competencies related to the role. Memorial Health also offers a comprehensive benefits plan, which includes paid time off, 401(k) match, and health/ dental/ vision insurance options. All benefits can be found at https://jobs.memorial.health/about/benefits/

If you require a reasonable accommodation to complete this application or participate in the hiring process, please contact [email protected]. Requests will be handled confidentially.