Case Manager/ Utilization Review RN- REMOTE

Feb 13, 2025

St. Mary's Health Care System

Case Management | Care Management, Clinical Coordinator | Navigator, Entry Level, Registered Nurse | RN, Utilization Management | Utilization Review
Remote

Employment Type:

Regular | Perm Employee

Schedule:

Full-time

Remote Status:

Remote

License:

Compact | Multistate - US, GA

St. Mary's Health Care System

Case Management | Care Management, Clinical Coordinator | Navigator, Entry Level, Registered Nurse | RN, Utilization Management | Utilization Review
Remote

Employment Type:

Regular | Perm Employee

Schedule:

Full-time

Remote Status:

Remote

License:

Compact | Multistate - US, GA

Employment Type

Full time

Shift

Day Shift

Description

The Utilization Review (UR) Coordinator works, in collaboration with a multidisciplinary team that includes, but is not limited to, physicians, nurses, patient access, and billing staff, along with external insurance payers, to ensure patients progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes. UR Coordinator utilizes established guidelines to support appropriate level of care throughout hospitalization and serves as a liaison between the hospital and external payers on issues related to severity of illness and intensity of service for patients to ensure appropriate and timely utilization of hospital services.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.