St. Tammany Health System

Healthcare

RNUtilizationManager(PRN)

$75–105k ~AI est. Covington, Louisiana, United States PART TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid+ candidates.

The Brief

“RN Utilization Manager (PRN) at St. Tammany Health System. Skills: Utilization review, Case management, Patient advocacy. Review patient charts for medical necessity. Coordinate patient care transitions”

What You'll Achieve.

Ensure appropriate level of care; Facilitate timely discharge planning; Optimize resource utilization

Industry & Context.

Healthcare
Problems you'll solve

Problem resolution

What They're Looking For.

Must Have

RN license required, Associate's degree required, 2 years of experience in utilization review

Nice to Have

BSN preferred, Case management certification preferred

What You'll Do.

Review patient charts for medical necessity

Coordinate patient care transitions

Collaborate with physicians and healthcare teams

Ensure compliance with payer requirements

Document all utilization review activities

Identify opportunities for process improvement

How You'll Work.

Team & Collaboration

Physicians; Healthcare teams; Payer representatives

Communication Scope

Patient communication; Physician communication

Full Job Description

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. **JOB DESCRIPTION AND POSITION REQUIREMENTS** Scheduled Weekly Hours: TBD **Work Shift:** 0800-1700 (flexible) **Summary of the Job:** The Utilization Manager is responsible to assist in the development, planning, coordination, and administration of the activities of Utilization Management. Job responsibilities include but are not limited to the following: daily review of medical records to determine appropriateness and medical necessity of admission, continued stay, use of resources, and discharge readiness. Assumes responsibilities delegated by the Department Head. **Minimum Qualifications:** Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing. Five years of hospital nursing experience preferred. Experience in the field of Utilization Management activities highly preferred. Basic understanding of CPT-ICD-9 coding principles and DRG management preferred. Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing. Ability to demonstrate effective written and verbal communication skills and possess emotional and professional maturity. Highly organized and efficient in establishing priorities and performing tasks within specific timeframes. Self-motivator requiring minimal supervision. Views problems as a challenge and investigates alternatives which demand creativity, flexibility and the ability to work under stress. Responsible for maintain

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