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RN, Utilization Management, FT, Days
Department Summary: The Utilization Management Department enacts the hospital UR Plan. The department provides for the assessment of the medical necessity of admission and continued stay, appropriate bed status, denials management, and outlier review. The department provides clinical information to third party payers to assure medical necessity requirements are met to secure authorization. Utilization Management Nurse Role: Utilization Management Nurses work within the multidisciplinary team to determine medical necessity of admission and continued stay in the hospital as well as correct patient classification and efficient use of resources. They conduct robust Utilization Review. Utilization Management N


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