Emory Healthcare/Emory University • Atlanta, GA 30309
Job #2692486032
Overview
Where you matter as much as the work you do
Join Emory Healthcare (EHC) if you're looking for an opportunity with one of the nation's leading Atlanta hospitals in cardiology and heart surgery, cancer, neurology, and more! EHC is where those around you are dedicated to the power of teamwork, fostering an environment where you can learn, grow, and innovate with similarly passionate professionals. Work with us to improve the quality of life throughout Georgia through partnerships with the U.S. Centers for Disease Control and Prevention, Georgia Institute of Technology, and other organizations and make a bigger, greater impact than you ever thought possible.
Description
We're seeking a Registry Utilization Management Analyst responsible for reviewing each hospital admission in accordance with nationally recognized criteria and department policies to determine the medical necessity of admission and appropriate LOS. This individual will:
Complies with established policies and procedures and implements appropriate changes to the Utilization Management process as directed.
Provides information including thorough, accurate and timely clinical updates to comply with regulations of third party payors and federal and state regulatory agencies and to obtain approvals of LOS and facilitate accurate payment of claims.
Issues and administers notices of non-coverage and potential of liability to clients in accordance with predetermined regulations, policies and procedures.
Maintains an effective flow of information between the nursing units, Social Services, physicians, Medical Records, Business Office and third party payors to facilitate appropriate lengths of stay (LOS) and to ensure appropriate reimbursement and coverage.
Minimum Qualifications
Graduate of an accredited nursing program.
Currently licensed as a Registered Nurse in the state of Georgia.
Two years of recent health care experience (within the past five years) and one year of experience in utilization management, quality improvement, or discharge planning.
A bachelor's degree in nursing or related health care field preferred.
JOIN OUR TEAM TODAY!Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network,establishedin 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.
Additional Details
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Connect with us for general consideration!
Division Emory Univ Hospital
Campus Location Atlanta, GA, 30322
Campus Location US-GA-Atlanta
Department EUH Utilization Review
Job Type PRN / Registry
Job Number 129418
Job Category Nursing
Schedule 8a-4:30p
Standard Hours 4 Hours
Hourly Minimum USD $0.00/Hr.
Hourly Midpoint USD $0.00/Hr.
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
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