Title: Utilization Management Nurse
Location: Philadelphia, PA
Under the general supervision of the Sr. Director, Case Management the Utilization Management Nurse provides comprehensive assessment, coordination, implementation and reporting of complex clinical data. The Utilization Management Nurse assesses the patients plan of care and progress of the patient throughout an acute care admission. The intensity of assessment is situational and appropriate based on payer requirements. This position is accountable for the communication of the clinical services delivered to identified payers and agencies
Skills / Experience:
Excellent communication skills and demonstrated organizational skills.
Ability to work effectively with all departments and all levels of CHOP professionals.
Ability to work independently or within a team structure.
Must be very organized and able to work independently.
Ability to establish priorities among multiple needs, meet deadlines and maintain standards of productivity.
Knowledge of managed care admission process (i.e. verification of benefits, admissions notification).
Ability to effectively negotiate with internal and external providers of patient care services.
Sound problem solving skills.
Excellent customer service orientation and strong interpersonal skills.
Computer skills and a working knowledge of Word, Excel and Access.
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