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Utilization Management Specialist RN
Overview M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides comprehensive assessment, planning, coordination, implementation, and reporting of complex clinical data. The utilization management specialist is responsible for the completion of admissions and continued stay reviews, obtaining insurance certification/authorization necessary to secure reimbursement. This position assesses the patients plan of care and progress of the patient throughout an acute care and/or outpatient episode across the Fairview system. The intensity of assessment is situational and appropriate based on payer requirements. The utilization management specialist concurrently monitors the appropriateness of admission and continued
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