Manager Utilization Review

Job description

'Manager of Utilization Review (RN) will lead our hospital's utilization management program. This key leadership position ensures that patient care is medically necessary, efficient, cost-effective, and compliant with all regulatory and accreditation standards. The Manager serves as a strategic and operational leader, working closely with nursing, care management, medical staff, and finance to optimize clinical outcomes and resource utilization across the continuum of care. The Managers should have an in-depth understanding of hospital utilization review processes, discharge planning, and medical necessity criteria. 'Bachelor's of Science in Nursing, Masters preferred. Minimum 5 years of acute care nursing experience in utilization review, care management, or discharge planning. Minimum of 2 years of supervisory or leadership experience in a hospital or healthcare setting. St. Joseph’s Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization’s outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in t...