Wound Care Utilization Management RN
Core
Utilization Management RN specializing in wound care, performing pre-certification and authorization for home health services to ensure clinical appropriateness and cost-effective resource use.
Role type
Licensed Nurse (Utilization Management)
Builds
Home health service authorizations and coordinated care plans for members with wound care needs
Domain
Healthcare / Wound Care / Home Health Services
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Wound care clinical expertise, Utilization Management experience, Care plan development, Clinical judgment, Resource monitoring, Telephonic/virtual review
Preferred skills
Home health experience, Compact nursing license, 1+ years in Utilization Management
Technologies
Electronic medical records, Telehealth platforms
Responsibilities
Review home-based services for clinical appropriateness, Develop coordinated care plans with providers, Facilitate timely discharges and transfers, Request additional clinical information from care providers, Educate patients on health choices, Monitor cost-effective use of resources
Seniority
Individual Contributor, Non-Management