What are the responsibilities and job description for the RN Utilization Mgmt Review Coordinator position at Mercy Health?
Employment Type:
Part timeShift:
Day ShiftDescription:
Performs Utilization Reviews for assigned cases, interacting with insurance representatives, case managers, and the physician advisor as needed. Coordinates the utilization review activities within the CQM department and serves as interdepartmental liaison as it relates to changes in the utilization management industry. In addition, assists with denial management of cases denied both concurrently and retrospectively.
What you will need:
- Bachelor of Nursing (BSN)
- Current State of Michigan Registered Nurse License
- Three years acute care experience as a Registered Nurse
- Preferred: Two years of recent acute care utilization management experience, experience in facility audits/appeals and process
What you will work:
Per Diem
Days
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.