Utilization Management Specialist - 40 Hours

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Type:

Regular

Scheduled Hours:

40

Work Shift:

Day (United States of America)

:

Winchester Hospital, a member of Beth Israel Lahey Health, has a new opening for a Utilization Management Specialist within our Magnet-designated 229-bed hospital.

This job will perform the following:

• Concurrent clinical reviews
• Medical necessity surveillance
• Coordination with financial team to ensure proper reimbursement
• Patient status oversight and management
• Promotes the documentation of medical necessity and resource consumption during an inpatient hospitalization

This position works in tandem with the case management department and may be called upon at any time to function in the role of case manager/care coordinator to accommodate departmental needs.

Qualifications:

Education

Required: Bachelors’ degree in Nursing (BSN) or obtain BSN within 5 years of hire

Preferred: BSN upon hire

Experience

Required

• Experience educating and/or formal presenting.
• At least five (5) years of clinical experience as a Registered Nurse

Preferred

• Previous Case Management or Utilization Review experience

FLSA Status:

Exempt

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled