What are the responsibilities and job description for the Utilization Management RN position at Insight Global Healthcare?
Job Description
Job Description
A large healthcare insurance company local to the Philadelphia area is looking for to hire a fully remote Case Management RN to join their Acute Care management team. Under the direction of a designated Care Management and Coordination Supervisor, performs telephonic or onsite review of hospital admissions, determining alternative settings when appropriate. Works to add value to healthcare by encouraging efficient and high quality use of the healthcare delivery system. Promotes timely and dynamic discharge planning to facilitate early discharge and refers cases to Case Management when indicated. Efficiently collaborates with the hospital utilization review department, attending physicians and members / families as appropriate.
Must Haves
3 years of UM experience working in the insurance field (Prior discharge planning and / or utilization management)
3 years of Acute Care experience
Familiarity with Interqual or CMS Standards
Active RN license (NJ, PA or DE)
