[Hiring] RN - Utilization Management @ProMedica

Role Description

As a Utilization Management RN, you look to maximize the quality and cost-efficiency of health care services at ProMedica. You will:

• Complete reviews for admissions and transfers
• Apply payer rules to obtain authorizations
• Work with physicians, nurses, and other members of the health care team to effectively allocate resources to ensure appropriate care
• Review cases and look for opportunities to improve hospital service utilization

The above summary is intended to describe the general nature and level of work performed by the positions. It should not be considered exhaustive.

Qualifications

• Graduate of approved NLN accredited School of Nursing
• Minimum of 3 years acute care nursing experience
• Current RN licensed in the state of hire

Requirements

• Bachelor’s degree (preferred)
• Knowledge of insurance guidelines and federal, state, and local regulations
• Experience with UR/UM in hospital acute care setting
• Previous experience with case management, utilization review, and InterQual criteria

Benefits

• Competitive benefits package with coverage effective day one of employment
• Dental and vision coverage
• Company paid life insurance
• Paid time off
• 401k retirement plan
• Employee assistance program
• Other voluntary coverage options and employee discounts

Company Description

ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including:

• Acute and ambulatory care
• A dental plan
• Academic business lines

ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health.

For more information about ProMedica, please visit promedica.org/aboutus .