Full Time 40 hours Grade 044 Utilization Management

8 AM-4:30 PM; WKNDS AS NEEDED

General Description

The Utilization Management Nurse role is a unique and exciting opportunity that blends the knowledge of nursing and the business aspects of the healthcare system. The position spans the entire healthcare system working collaboratively with Health Information Management, Financial Counselors, Patient Financial Services, Physicians, Social Work, patients, and various insurance companies. The UM RN is responsible for the review of clinical documentation utilizing evidence-based criteria to support medical necessity and appropriate level of patient care for services provided. The UM RN is also responsible for reviewing outcome trends and patterns to identify educational opportunities and performance improvement processes across the healthcare continuum. In addition, the UM RN is responsible for auditing the quality of clinical documentation and providing education based on findings. The role requires strong communication skills and critical thinking skills. Primarily Monday through Friday with occasional off-shift and weekend commitments depending on the needs of the department. The majority of work is remote with some on-site requirements as needed.

Qualifications:

RN with Utilization Review experience preferred; 3-5 years of recent acute hospital experience preferred.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled