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19102, Philadelphia, PA
RN- Utilization Review- Part-time Weekends (Temple Hospital)

Sonic Summary

The position involves reviewing patient admissions and continued stays using InterQual and other criteria to ensure compliance with the hospital's utilization management plan.
The role requires determining medical necessity for patient care within the department's scope to maintain high-quality patient services and efficient use of health resources.
Candidates must have a Bachelor's Degree in Nursing (BSN) and a minimum of one year of recent experience in Utilization Review within an acute care or insurance setting.
Additionally, applicants should have one year of experience in a medical-surgical setting and competency in utilizing InterQual criteria.
The salary for this position is competitive, and a PA Registered Nurse License is required, with a Certified Case Manager designation preferred.

Utilizing InterQual and other appropriate criteria, responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospital's utilization management and quality assurance plan. Will determine the medical necessity for admission and continued stays for patients within department's scope of service and to meet the hospital's objectives for assuring a high quality of patient care as well as assuring the effective and efficient utilization of available health services. Identifies appropriate level of care for inpatients and outpatients requiring overnight care.

Education
Other Graduate of an accredited school of nursing Required
Bachelor's Degree BSN Required

Experience
1 year experience of recent Utilization Review in acute care or in insurance company setting. Required
1 year experience in medical-surgical setting. Required
1 year experience in working with competency utilizing InterQual criteria. Required
General Experience in working with utilization review standards Required

Licenses
PA Registered Nurse License Required
Certified Case Manager Preferred
Multi State Compact RN License Required Or

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RN- Utilization Review- Part-time Weekends (Temple Hospital)