Job Description
Up To $25,000 Sign On Bonus For Qualified RNs!
Summary
The Registered Nurse (RN) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, payers, and the Guthrie Clinic health system business office, is responsible for developing, coordinating, and maintenance of UM processes based on regulatory and reimbursement requirements of commercial and government payers. The UM RN responsibilities include performing a variety of concurrent and retrospective UM-related clinical reviews and revenue cycle functions ensuring appropriate status and corresponding reimbursement.
The UM RN leads and/or actively participates in process improvement initiatives, working with a variety of departments and multi-disciplinary staff. The UM RN maintains current knowledge regarding commercial and government payers and Joint Commission regulations/guidelines/criteria related to UM.
This role is responsibl...
Summary
The Registered Nurse (RN) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, payers, and the Guthrie Clinic health system business office, is responsible for developing, coordinating, and maintenance of UM processes based on regulatory and reimbursement requirements of commercial and government payers. The UM RN responsibilities include performing a variety of concurrent and retrospective UM-related clinical reviews and revenue cycle functions ensuring appropriate status and corresponding reimbursement.
The UM RN leads and/or actively participates in process improvement initiatives, working with a variety of departments and multi-disciplinary staff. The UM RN maintains current knowledge regarding commercial and government payers and Joint Commission regulations/guidelines/criteria related to UM.
This role is responsibl...