Utilization Management Specialist

Full Time
Minneapolis, MN 55407
Posted
Job description
Department: 16001168 Revenue Cycle Management Utilization Management
Shift: Permanent Evenings (United States of America)
Hours: 28
Contract: Non-Union
Weekend Rotation: Alternative Weekend Plan
Job Profile Summary: Collaborates with the care team to confirm the level of care and authorization for services. Reviews medical records and prepares clinical reviews for medical necessity and authorization. Is also responsible for facilitating the denial and appeal process.
Job Description:


Job Requirements

  • Associate's or Vocational degree in nursing if a current Allina Health employee required or
  • Bachelor's degree in nursing required
  • Licensed Registered Nurse - MN Board of Nursing required upon hire
  • 2 to 5 years experience in an acute hospital setting required
  • 2 to 5 years case management experience preferred or
  • 2 to 5 years utilization management experience preferred
  • Less than 2 years experience using InterQual, MCG, or other admission criteria preferred
  • Must live and work out of MN or WI only
  • High-speed internet connection with low latency or interference required

Shift Information:

  • Fully remote position - Evening Shift Needs
  • Required to work 1-2 holidays per year
  • Required weekend rotation
  • Flexible shift start times


`Physical Demands

Sedentary:
Lifting weight Up to 10 lbs. occasionally, negligible weight frequently


Additional Job Description:

Shift Information:

  • Fully remote position - Evening shift needs
  • Required to work 1-2 holidays per year
  • Required weekend rotation
  • Flexible shift start times

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