RN, Registered Nurse Utilization Management

Children's Hospital of Philadelphia (CHOP) is seeking an experienced RN, Registered Nurse Utilization Management professional to join our team. This position requires excellent clinical, communication and organizational skills, as well as a commitment to providing high quality care. The ideal candidate for this position is an experienced RN with a passion for making a difference in the lives of children and families.This role is critical to ensuring that CHOP is providing the highest quality of care to our patients. The RN, Registered Nurse Utilization Management will collaborate with physicians and other health care team members to optimize utilization of resources while providing quality care to patients. The successful candidate must possess strong clinical skills combined with exceptional interpersonal skills.

Responsibilities:

1. Develop and implement utilization management policies and procedures to ensure quality of care and cost-effectiveness for patients.
2. Collaborate with physicians, other health care team members, and other stakeholders to identify opportunities for improvement and develop action plans.
3. Monitor utilization of resources and ensure compliance with regulatory and accreditation standards.
4. Participate in the development and implementation of new policies and procedures, and review existing policies and procedures.
5. Conduct utilization reviews for inpatient and outpatient services, and provide data-driven recommendations for improvement.
6. Maintain patient records and document all utilization management activities.
7. Educate and inform physicians and other health care professionals on utilization management.
8. Serve as a liaison between CHOP and external payers to ensure proper reimbursement for services.
9. Monitor and analyze utilization trends to identify cost-saving opportunities.
10. Provide consultation to other departments and stakeholders regarding utilization management.

According to JobzMall, the average salary range for a RN, Registered Nurse Utilization Management in Philadelphia, PA, USA is $78,000 to $98,000 per year.

The Children's Hospital of Philadelphia, also known by its acronym CHOP, is a children's hospital in Philadelphia, Pennsylvania. Its primary campus is located in the University City neighborhood of West Philadelphia on the campus of the University of Pennsylvania. The hospital has 594 beds and more than one million outpatient and inpatient visits annually. It is one of the world's largest and oldest children's hospitals and the first hospital dedicated to the healthcare of children.