Job Title: Utilization Review Nurse $12K Sign-on-bonus & Relocation

Under the general direction of the Director of Case Management, provides care using the principles of Case Management and Social Work to move patients through the continuum of care. Competency is based on the UR Nurse ability to monitor utilization of resources, coordinate and facilitate appropriate services and operational resources, and provide discharge planning based on goals of care, treatment preferences, and available resources include appropriate length of stay, resource utilization, and continuity of care, cost control, customer satisfaction and compliance with regulations, laws, and hospital policies governing Case Management and UR services. Communicates with physician, utilization review, ancillary staff, community allied providers, and payers, to assist in arranging transfers or alternate placement when indicated, and to ensure quality care is provided and desired outcomes are achieved in a timely and cost-effective manner. Utilizes a complete and systematic methodology/process to assess, plan, implement, evaluate and provide patient care coordination from pre-hospital through post-hospital care. Works to reduce incidents of readmission. Works within regulatory compliance guidelines. Communicates with payers to obtain authorization for any care coordination needs. Identifies and plans strategies to optimize inpatient length of stay and resource utilization. The UR Nurse is responsible for completing other duties as assigned.