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Utilization Review Registered Nurse, PRN

Part-time

Trinity Health

Athens, GAPart-timePosted 1 day agoStill listed today

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At a glance

Compensation
No compensation found
Location
Athens, GA
Schedule
Part-time
Work Authorization
Not specified

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Job overview

The Utilization Review Coordinator collaborates with a multidisciplinary team to ensure patients receive appropriate, efficient, cost-effective, and quality-focused care. The role conducts clinical reviews using established medical necessity criteria to support patient status determinations and resource utilization during hospitalization. It also serves as a liaison between the hospital and external payers on medical necessity, severity of illness, intensity of service, authorization requirements, and timely use of hospital services.

Skills & qualifications

RequiredNice to have

Skills

Utilization ReviewMedical Necessity CriteriaPatient Status DeterminationResource UtilizationPayer Liaison

Full job description

Employment Type: Part timeShift:

Description: Position Summary: The Utilization Review (UR) Coordinator collaborates with a multidisciplinary team, including physicians, nurses, patient access staff, billing personnel, and external payers, to ensure patients receive the appropriate level of care throughout the continuum of care in an efficient, cost-effective, and quality-focused manner. The UR Coordinator conducts clinical reviews using established medical necessity criteria to support accurate patient status determinations and appropriate resource utilization throughout hospitalization. This role serves as a liaison between the hospital and external payers regarding medical necessity, severity of illness, intensity of service, authorization requirements, and timely utilization of hospital services.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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