Utilization Review Specialist - Care Management; Casual

Job Description

St. Mary's Medical Center is seeking a Full Time Utilization Review Specialist for our Care Management Department
. The Utilization Review Manager exercises independent judgement and professional discretion in the practice of case management to patients. The URS collaborates with physicians to ensure that patients are at the appropriate level of care with use of clinical based guidelines such as Inter Qual/MCG. The URS monitors continuing stay to protect solving skills to meet the needs of the patients and physicians while meeting the contractual guidelines of our payers.

Education Requirements:

Graduate of an approved school of nursing; holds and maintains current Registered Nursing License for the state of West Virginia.

BSN, Master Degree preferred, not required.

Experience:

Five years nursing experience. Minimum experience includes: patient care in the hospital setting, direct knowledge of care management, discharge planning and resource management.

Certifications/

Skills:

Certifications in Care Management preferred, not required. BLS required.

This Company is an Equal Opportunity Employer, and does not discriminate on the basis of race, gender, ethnicity, religion, national origin, age, disability, veteran status, or on any other basis prohibited by law. Information on race, gender and national origin will only be used for statistical and recordkeeping purposes, and will not be used in making any employment decisions. All information provided will be kept separate from your expression of interest.

Providing this information is strictly voluntary, and you will not be subjected to any adverse action or treatment if you choose not to provide this information. If you do not choose to answer these questions, we ask that you select "Decline to Identify" for each question. Thank you for your voluntary cooperation.