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RN Utilization Management

Company: Johns Hopkins All Children's Hospital
Location: Saint Petersburg
Posted on: February 15, 2019

Job Description:


The RN Utilization Managers (RN-UM) purpose is to collaborate with various internal and external stakeholders to advocate for the patient ensuring high quality cost-effective care while balancing the responsibility of organizational stewardship and judicial management of hospital resources of the acute care patient population. Using clinical findings, Interqual evidence based criteria and JHACH policies/practices to perform utilization reviews for admissions, continued stays, and adverse determinations following escalation process defined in the JHACH UM Plan. The RN-UM counsels providers and other healthcare team members around avoidable delays/days, identification of organizational development opportunities, utilization and denial management, and throughput and practices within the scope and standards of practice as defined by the Florida State Board of Nursing and the American Case Management Association.


BSN required.

Current Florida RN Licensure.

Minimum of 2 years of pediatric acute hospital experience. Case Management and/or Utilization Management experience preferred.

Writing and computer skills to include accurate typing skills, proficiency in Windows, Microsoft Word, Outlook, and Excel, electronic medical record, and other clinical platforms.


Day Shift

One weekend day per pay period required

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Keywords: Johns Hopkins All Children's Hospital, St. Petersburg , RN Utilization Management, Executive , Saint Petersburg, Florida

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