ChristianaCare - Union Hospital is seeking Utilization Management Nurse with experience in Utilization Management and Acute Care. The RN will be responsible for ensuring the delivery of efficient and effective health care while evaluating the medical necessity appropriateness and efficiency of the use of health care services procedures and facilities under the provision of the applicable health benefits plan.
SCOPE PURPOSE AND FREQUENCY OF CONTACTS:
Ongoing contact with patient/families medical-dental staff nursing social work PI-outcome coordinators disease management and ancillary services; additional contact with home health care providers durable medical equipment providers insurance/managed care organizations and community resources.
EDUCATION AND EXPERIENCE REQUIREMENTS:
Maryland or Compact State RN Licensure Required.
A Bachelor of Science in Nursing (BSN) must be obtained within three years of hiring.
Candidates with an Associate Degree in Nursing (ADN) will be considered if they have at least six years of experience as a Registered Nurse (RN) and relevant work experience in Utilization Management Case Management or Home Care is preferred.
Maintain documented hours of relevant continuing education related to licensure requirements. Some continuing education should be related to role enhancement and changes of clinical practice within the assigned area.
Current BLS
Case Management Certification (CCM) required within 18 months of eligibility.
KNOWLEDGE SKILL AND ABILITY REQUIREMENTS:
Strong interpersonal skills relative to both professional and lay interactions. Strong organizational skills. Working knowledge of Performance Improvement activities. Working knowledge of data management/reporting practices
PHYSICAL DEMANDS:
Ability to ambulate within the hospital setting (walking stairs etc.). Occasional sitting standing and lifting loads of 5-10 pounds. Ability to utilize computer equipment/programs
Christiana Care Health System is an equal opportunity employer firmly committed to prohibiting discrimination whose staff is reflective of its community and considers qualified applicants for open positions without regard to race color sex religion national origin sexual orientation genetic information gender identity or expression age veteran status disability pregnancy citizenship status or any other characteristic protected under applicable federal state or local law.
Post End Date
Jan 13 2026EEO Posting Statement
ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family including health insurance paid time off retirement an employee assistance program. To learn more about our benefits for eligible positions visit Experience:
Manager