Integration Manager
Redox
Senior Integrated Care Manager, Utilization Review Department - Hybrid
Sentara Health
full-time
Posted on:
Location: Virginia • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Senior Integrated Care Manager, specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure.
- Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review.
- Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements.
- Responsible for written and /or verbal communication of pertinent clinical information.
- Location: Hybrid in Norfolk, VA; reports to Sentara Patient Accounting.
Requirements
- Bachelors Degree in Nursing REQUIRED
- Registered Nurse (RN) License (Compact or Virginia) REQUIRED
- 3 years experience in Nursing REQUIRED
- Acute Care and Utilization experience preferred
