Registered Nurse | Utilization Management

Description As an integral part of the St Cloud Hospital Care Management team, the Utilization Review Nurse collaborates with other Care Management staff, physician/providers, physician advisors, and leadership to determine the most appropriate level of care for each hospital patient admission.

Coordinates with the billing department, claims analysts, hospital insurance representatives, and Revenue Cycle department to ensure accurate claims are submitted for reimbursement.

Responsible to conduc…