RN Utilization Management
Requisition #: 177199
Location: Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701
Work Shift: Evening Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Nov. 20, 2018
Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
The RN Utilization Manager’s (RN-UM) purpose is to collaborate with various internal and external stakeholders to advocate for the patient ensuring high quality cost-effective care while balancing the responsibility of organizational stewardship and judicial management of hospital resources of the acute care patient population. Using clinical findings, Interqual evidence based criteria and JHACH policies/practices to perform utilization reviews for admissions, continued stays, and adverse determinations following escalation process defined in the JHACH UM Plan. The RN-UM counsels providers and other healthcare team members around avoidable delays/days, identification of organizational development opportunities, utilization and denial management, and throughput and practices within the scope and standards of practice as defined by the Florida State Board of Nursing and the American Case Management Association.
Current Florida RN Licensure.
Minimum of 2 years of pediatric acute hospital experience. Case Management and/or Utilization Management experience preferred.
Writing and computer skills to include accurate typing skills, proficiency in Windows, Microsoft Word, Outlook, and Excel, electronic medical record, and other clinical platforms.
One weekend day per pay period required
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.