RN Utilization Management (UM)

Job Title: RN Utilization Management (UM)
Locations: York, PA 17402
Duration: 5 Weeks + Extension


Shift Timings: 8:00 AM to 5:00 PM


Summary:
We are seeking an experienced RN Utilization Management professional to review clinical information, determine medical necessity, and ensure appropriate utilization of healthcare services.

Responsibilities:
· Review medical records and clinical documentation for medical necessity.
· Perform utilization and case reviews according to established guidelines.
· Coordinate with providers, case managers, and healthcare teams.
· Monitor patient care, length of stay, and appropriate level of care.
· Maintain accurate documentation and ensure compliance with policies and regulations.

Requirements:
· Active RN license.
· Previous Utilization Management/Review experience preferred.
· Strong clinical assessment and documentation skills.
· Knowledge of healthcare guidelines and medical necessity criteria.
· Strong communication and organizational skills.