RN Utilization Review Full-time
IU Health

Registered Nurse-Utilization Management (Acute Rehab Unit)

IU Health Muncie, IN 47303, US

Overview

Registered Nurse – Utilization Management (Acute Rehab Unit)

Ball Memorial Hospital | Muncie, Indiana Full-Time | Day Shift Monday-Friday | 8:00 AM - 4:30 PM No Call • No Weekends • No Holidays

Join Our Team

Ball Memorial Hospital is seeking a dedicated Registered Nurse - Utilization Management to support our Acute Rehabilitation Unit. This role offers an excellent opportunity for an experienced RN who enjoys combining clinical expertise with care coordination, utilization review, and patient advocacy to ensure patients receive the right care at the right time throughout their healthcare journey.

In this position, you will serve as a critical liaison between patients, providers, payers, and the interdisciplinary care team to promote quality outcomes, appropriate resource utilization, and seamless transitions of care.

What You'll Do

  • Conduct utilization review activities for inpatient admissions, outpatient procedures, and ancillary services.
  • Perform pre-certification, concurrent, and retrospective reviews to ensure medical necessity and appropriate levels of care.
  • Apply established clinical review criteria, regulatory requirements, and payer guidelines to assess appropriateness of services.
  • Collaborate with physicians, rehabilitation specialists, case managers, and interdisciplinary care teams to optimize patient outcomes.
  • Coordinate and support discharge planning efforts to facilitate safe and timely transitions across the continuum of care.
  • Advocate for patients by expediting access to medically necessary services and removing barriers to care.
  • Monitor compliance with documentation, quality standards, and utilization management policies.
  • Promote efficient, cost-effective healthcare delivery while maintaining a strong focus on quality and patient-centered care.
  • Serve as a clinical resource related to utilization management, reimbursement, and care coordination processes.

 

Why You'll Love This Opportunity

  • Day shift schedule with excellent work-life balance
  • No call requirements
  • No weekends
  • No holidays
  • Opportunity to leverage your clinical expertise in a collaborative, multidisciplinary environment
  • Make a meaningful impact on patient outcomes and care transitions
  • Professional growth within a highly respected healthcare organization

 

Qualifications

  • Requires an Associates of Nursing (ASN).
  • Bachelors of Nursing (BSN) preferred.
  • Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
  • Requires that the RN has graduated from a nationally accredited nursing program.
  • Requires 3-5 years of relevant experience. Inpatient nursing experience preferred.
  • Basic Life Support certification through the AHA or other advanced life support certifications may be required per unit/department specialty according to patient care policies.
  • Requires proficiency in Microsoft Office and applications.
  • Requires understanding of medical record requirements, regulations and policies.

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