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 InterQual/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.
Qualifications
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
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