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Utilization Review Nurse Per Diem Job

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Date: Nov 14, 2017

Location: St Paul, MN, US

Company: HealthPartners

Job Description:


Perform daily Utilization Management program functions that facilitate care delivery and meet conditions for reimbursement.. The case manager will collaborate with the care team including, but not limited to: attending/specialty physician(s), Social Work, therapies, Care Management, and Nursing to ensure that and effective and timely care is provided. Provides services on occasional weekends and/or holiday(s) as determined by leadership.



Associate’s degree of nursing with RN licensure from and accredited college or university; bachelor’s or master’s degree of nursing preferred.


* Minimum 1-3 year experience working as a Registered Nurse in a clinical setting performing utilization review, case management or discharge planning, care and/or quality improvement. 3 years experience is preferred.
* Knowledge of reimbursement systems required

Knowledge, Skills & Abilities:

* Experience with utilization review criteria and/or progression of care guidelines
* Public health, homecare or hospital case management/utilization review experience required
* Experience with hospital inpatient admission/observation criteria.
* Function independently and as part of a team, working effectively with various facilities, internal and external staff, patients, patients’ family, and physicians to facilitate patient care
* Excellent verbal, written and interpersonal skills
* Excellent problem identification, problem-solving skills, and follow through skills
* Ability to deal with change and ambiguous situations
* Ability to work with individuals of diverse backgrounds
* Extensive computer familiarity. Experience with Microsoft office products, email, electronic medical records, and other specialized software. Working knowledge of EPIC and/or Allscripts software beneficial

Licensure/ Registration/ Certification:

Current State of Minnesota Nursing Board license

Additional Information:

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Nearest Major Market: Minneapolis

Job Segment: Nursing, Medical, EMR, Patient Care, Public Health, Healthcare

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