St. Jude Children's Research Hospital

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Utilization Review Coordinator

Utilization Review Coordinator

Job ID 
36736
Department 
Patient Business Services
Category 
Business Support
Job Location 
US-TN-Memphis

More information about this job

Summary

Assists in maintaining the Utilization Review program for the Patient Business Services Department. Obtains authorizations/certifications from insurance companies/third party payors for services provided at St. Jude. Assists in the development of Process Improvement tools in the Utilization Review Department and Patient Business Services.

Minimum Education

  • Graduate of an accredited RN program

  • Bachelors' Degree in Nursing or a related area preferred

Minimum Experience

  • Three (3) years related medical experience

  • Six (6) months experience in a hospital environment required

  • Utilization review experience preferred

  • Experience with InterQual guidelines and Cerner systems preferred

Required Credentials

  • (LC:RN-TN) Must possess a current Tennessee State Board of Nursing license if primary residence is Tennessee or a Nurse Licensure non-Compact state.
    (LC:RN-MISS, RN_ARK or RN-KY) Must possess a current State Board of Nursing license in the state of primary residence if the state is a Nurse Licensure Compact state

Other Credentials

  • Certified Case Manager preferred

EEO

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