Contract Length: 9 Weeks
Shift: Day Shift
We are seeking an experienced RN Utilization Management (RN UM) to support Milford Center during this short-term assignment. This role is ideal for a Registered Nurse with strong clinical judgment and prior experience in post-acute care, care coordination, and utilization review. The RN UM will ensure that resident care plans align with clinical needs, regulatory requirements, and facility standards.
Conduct utilization reviews to ensure appropriate levels of care and compliance with clinical guidelines.
Review clinical documentation for accuracy, completeness, and alignment with regulatory and reimbursement requirements.
Collaborate with interdisciplinary teams to coordinate care transitions and support optimal patient outcomes.
Monitor patient progress and provide recommendations related to care needs and service authorizations.
Support quality assurance initiatives and contribute to efficient facility operations.
Communicate professionally with internal teams, providers, payers, and external partners as required.
Provide flexible support to meet facility needs.
Active and unencumbered RN license in the state of practice.
Required: Experience in Post-Acute Care.
Prior experience in utilization management, case management, or care coordination strongly preferred.
Strong knowledge of clinical documentation standards, regulatory requirements, and reimbursement processes.
Excellent communication, critical thinking, and organizational skills.
Ability to work independently with strong attention to detail.