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Utilization Management Nurse, RN
Saint Francis Health SystemUtilization Management Nurse supporting clinical and administrative teams at Saint Francis Health System. Involves patient reviews and communication with providers regarding reimbursement issues.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in providing administrative and clinical support within an acute care setting, including effective communication with providers regarding reimbursement and patient eligibility. Proficient in discharge planning and preparing clinical information for insurance authorization.
Highest-signal resume keywords
Registered Nurse LicenseAcute Care ExperienceClinical SupportCommunication SkillsMicrosoft Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical SupportPatient Eligibility ReviewDischarge PlanningInsurance Appeals PreparationAuthorization Information Gathering
Soft Skills
Interpersonal SkillsOrganizational SkillsPrioritization SkillsWritten Communication SkillsOral Communication Skills
Tools & Technologies
Microsoft WordMicrosoft ExcelMicrosoft Access
Certifications & Qualifications
Registered Nurse License
Industry Keywords
Acute Care SettingReimbursement IssuesTreatment TeamsClinical InformationLevel of Care Utilization
About the role
Key responsibilities & impact- Provides administrative and clinical support to the hospital and treatment teams
- Communicates with providers about reimbursement issues
- Participates in treatment teams and committees
- Gathers and prepares clinical/treatment information for authorization
- Assists in discharge planning
- Reviews patient eligibility and benefits for level of care utilization
- Investigates and prepares appeals for insurance companies
Requirements
What you’ll need- Has completed the basic professional curricula of a school of nursing
- Holds or is entitled to hold a diploma or degree in Nursing
- Valid multi-state or State of Oklahoma Registered Nurse License
- Minimum 2 years of related experience in an acute care setting
- Ability to organize and prioritize work effectively
- Effective interpersonal, written, and oral communication skills
- Working knowledge of Microsoft Word, Excel and Access
Benefits
Comp & perks- Flexible work arrangements
- Professional development opportunities