Pennsylvania Licensed Utilization Management RN

Job Summary

To support efficient healthcare services, the part-time remote Pennsylvania Licensed Utilization Management RN will perform telephonic reviews of hospital admissions, determine medical necessity, and collaborate with healthcare providers and families to facilitate appropriate care transitions.

Key responsibilities

• Perform telephonic utilization management reviews for inpatient admissions and determine medical necessity
• Collaborate with hospital case management teams and physicians to facilitate appropriate discharge planning
• Maintain accurate documentation and ensure compliance with state, federal, and accreditation requirements

Required qualifications

• Active Pennsylvania RN license or Compact RN license that includes Pennsylvania
• Minimum 3 years of acute care clinical experience in a hospital or healthcare setting
• Prior discharge planning and/or utilization management experience required
• BSN preferred
• Must reside in Pennsylvania, New Jersey, or Delaware