RN - Utilization Management Specialist (2 openings)
Location: Minnesota
Description: Fairview Health Services is in need of RN - Utilization Management Specialist (2 openings) right now, this position will be placed in Minnesota. More complete informations about this position opportunity please give attention to these descriptions. This position provides comprehensive assessment, planning, coordination, implementation and reporting of complex clinical data.! The utilization management specialist is responsible for the completion of admissions and continued stay reviews, obtaining insurance certification/authorization necessary to secure reimbursement. This position assesses the patient’s plan of care and progress of the patient throughout an acute care and/or outpatient episode. The intensity of assessment is situational and appropriate based on payer requirements. The utilization management specialist concurrently monitors the appropriateness of admission and continued stay days using Intensity of Service/Severity of Illness (IS/SI) criteria. This position identifies/resolves barriers which may hinder effective patient care. Assists with other departmental duties as needed.
Job Qualifications:
Bachelor's in nursing or currently in the position within the Fariview system (grandfather status). MN RN licensure required by start date.
Three years of utilization review, hospital case management or ex! perience within a health plan preferred.
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If y! ou were eligible to this position, please email us your resume, with salary requirements and a resume to Fairview Health Services.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Fri, 25 Oct 2013 19:40:19 GMT
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