UR Specialist - BSN

Parkview Health

Fort Wayne, IN

JOB DETAILS
LOCATION
Fort Wayne, IN
POSTED
30+ days ago








Summary



Continuously verifies, negotiates alternatives and manages care of an assigned patient group to facilitate the achievement of quality and cost effective outcomes and reimbursement for services. Responsible for utilization of systems to obtain certification for payment and utilization review. Participates in quality improvement and evaluation processes related to Utilization Review.







Education



Bachelor of Science in Nursing (BSN) required.







Licensure/Certification



Must be an RN with current license.



Experience



Must have three years recent full-time utilization review, patient accounting or revenue cycle experience or three years of clinical experience in an acute care setting. Preferred experience in Case Management activities and Utilization Review.







Other Qualifications



Demonstrates knowledge of DRG, managed care initiatives, payment methods and statistical analysis. Demonstrates understanding of managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to problem solve efficiently and effectively. Must have good organizational skills and flexibility with dealing and multiple tasks at the same time.







About the Company

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Parkview Health

Welcome to Parkview
Here, you’ll find a health system dedicated to meeting your needs throughout your health journey. With 14 hospitals, 50+ clinical specialties, an extensive network of expert providers, and access to advanced technologies typically only found at academic medical centers, Parkview is improving the health of our entire region. We are continually expanding our knowledge, discovering novel ways to care for patients, and connecting our community to the supportive expertise they deserve. We are Parkview. And we are advancing healthcare to be better for you every day.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
WEBSITE
https://www.parkview.com/