Utilization Management Nurse-1 en Medical University of South Carolina · MUSC HEALTH AT TIDELANDS

Sobre este puesto de Utilization Management Nurse-1 en Medical University of South Carolina

Medical University of South Carolina · Presencial · MUSC HEALTH AT TIDELANDS

Job Description Summary

MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina.

Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.

Entity

MUSC Community Physicians (MCP)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC005921 MCP - Utilization Management

Pay Rate Type

Hourly

Pay Grade

Health-28

Scheduled Weekly Hours

Work Shift

Job Description

Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with physicians as needed.

Bachelor's degree in Nursing from an accredited school of nursing and three years’ work experience as a Registered Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in regards to education requirement. Must possess excellent verbal and written communication skills. Familiarity with InterQual or Milliman and Robinson screening criteria desired. Licensure as a registered nurse by the state of South Carolina or compact state required.

Additional Job Description

Benefits:

Health, dental, vision, and life insurance
Employer Sponsored Retirement Plan
Paid time off and extended sick leave
Paid Parental Leave
Disability insurance plan options
Continuous professional and clinical training
Competitive pay
Annual Merit Increase
Wellbeing resources
Tuition Reimbursement
Employee perks and discounts
Employee referral program
Flexible schedule options
Certification incentive program

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

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Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramura

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