RN / Registered Nurse - Utilization Management - ...

Overview The Registered Nurse provides nursing care to individuals and groups which require specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavioral, social, spiritual/cultural, and nursing sciences. The Registered Nurse functions within the full scope of nursing practice as noted by the Board of Nursing of their designated state for which they are practicing in addition to compliance with any of the hospitals accrediting bodies. Full-Time Level: Mid Travel: No SuccessProfile Who is the ideal Promedica employee? We''re looking for people to join our team who are motivated by making an impact and doing meaningful work. Responsible 10 Compassionate 9 Communicator 9 Adaptable 9 Multi-tasker 8 Additional success profiles: Detail oriented, Flexible, Helpful, Patient, Responsible, Sincere, Understanding Benefits Professional Growth Retirement & Savings Plan Innovative Training Programs Tuition AssistanceCareer Stability Comprehensive Health Coverage Job Requirements ProMedica Monroe Regional Hospital offers a broad range of inpatient and outpatient services in southern Michigan and Ohio. A national leader in treatment of heart attack, congestive heart failure, pneumonia and surgical care, ProMedica Monroe Regional Hospital is also a pacesetter in Michigan for obstetrics, emergency care, intensive care, controlling infections and organ donation. "‹ Position Summary Conduct concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff, Joint commission, CMS and other state agencies. Prospectively or concurrently determines the appropriateness of inpatient or observation services following review of medical documentation, medical guidelines and insurance benefits and communicates information to payers in accordance with contractual obligation. Graduate of a professional school of nursing with licensure as an RN in the State of Michigan. At least 5 years of clinical experience, Psychiatric Nursing preferred. Case Management or Insurance Verification experience preferred. Superior skills in clinical judgement, organization and self motivated. Bachelor''s degree preferred. ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact [Click Here to Email Your Resumé] Equal Opportunity Employer/Drug-Free Workplace

Created: 2025-11-15