[Hiring] Registered Nurse - Clinical Access Specialist @Geisinger

Role Description

As one of the Top 8 Most Innovative Healthcare Systems in Becker’s Hospital Review, we’re working to create a national model for improving health. Today, we’re focused on bringing our region services that improve every facet of life to drive total health, inside and out.

Through professional growth, quality improvement, and interdisciplinary collaboration, we’ve built an innovative culture that allows for growth of your skillsets and the opportunity to leverage your years of experience to build a rewarding, lasting career with impact.

The Clinical Access Specialist RN performs utilization review, medical necessity assessments, and authorization activities to promote quality outcomes, timely reimbursement, and effective care transitions. Responsibilities include:

• Reviewing clinical documentation
• Verifying coverage and certification requirements
• Collaborating with physicians and care teams
• Serving as a resource on payer guidelines and discharge planning
• Maintaining accurate utilization review records
• Supporting documentation integrity
• Ensuring compliance with state, federal, and third-party payer standards

A typical schedule is 7:30 am to 4 pm with some evening, weekend, and holiday rotation.

Qualifications

• At least three (3) years of RN work experience is required
• Previous experience in an acute care setting is highly preferred
• Previous Utilization Management experience is highly preferred
• BSN is preferred

Requirements

• Graduate from Specialty Training Program-Nursing (Required)
• Minimum of 3 years-Nursing (Required)
• Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania

Benefits

• Healthcare benefits for full-time and part-time positions from day one, including vision and dental
• Encouragement of an atmosphere of collaboration, cooperation, and collegiality