Utilization Management Nurse

MMHC provides per diem, contract, contract to hire and direct hire assignments in a diverse set of disciplines and locations nationwide, offering support staff 24 hours a day, 7 days a week. Our extensive network of hospitals, managed care organizations, corporate wellness, community health centers, ambulatory, nonprofits, skilled nursing, schools and imaging centers enables us to provide ongoing opportunities to nurses and allied health professionals.

Location: Remote Employment Type: Contract Compensation: Salary Range: $40.00-$48.00 Per HR Description: Conduct telephonic or onsite reviews of hospital admissions. Encourage efficient and high-quality use of healthcare delivery systems. Facilitate early discharge and refer cases to Case Management when necessary. Collaborate with hospital utilization review departments and physicians.

Perform utilization management for inpatient admissions. Establish the need for inpatient and continued stay using medical criteria. Direct care delivery to the most appropriate setting while maintaining quality. Identify inpatient admissions not meeting criteria and refer to Medical Directors. Collaborate with hospital case management staff to determine alternative settings. Identify and refer cases for case and disease management. Maintain accurate data entry in compliance with regulations.