Job summary
Job post source
This job is directly from Cone Health
Job overview
The RN Utilization Review at Cone Health ensures medical necessity and appropriate care levels for hospital admissions and stays, impacting patient care quality and compliance.
Responsibilities and impact
The RN conducts timely case reviews, documents in EPIC, liaises between physicians and payors, oversees resource use, educates healthcare teams on compliance, monitors authorizations, and supports documentation to minimize denials.
Experience and skills
Requires a Bachelor's degree in Nursing, 3 years of RN experience, and a valid RN license in North Carolina or a Compact state.
Company overview
Cone Health is a not-for-profit healthcare network serving the Piedmont Triad region of North Carolina. It operates a comprehensive range of medical facilities, including hospitals, outpatient clinics, and specialty care centers, providing services from primary care to advanced surgical procedures. Established in 1953, Cone Health has grown through strategic acquisitions and partnerships, focusing on patient-centered care and community health initiatives. Revenue is generated through patient services, insurance reimbursements, and government programs, with an emphasis on reinvesting profits into improving healthcare services and infrastructure.
How to land this job
Position your resume to highlight your nursing experience, especially in utilization review, patient care coordination, and knowledge of regulatory compliance within hospital settings at Cone Health.
Emphasize your proficiency with EPIC and electronic medical records, your ability to conduct timely case reviews, and your experience collaborating with physicians and interdisciplinary teams.
Apply through Cone Health's corporate careers page, LinkedIn, and other healthcare job boards to maximize your chances of being noticed for the RN Utilization Review role.
Connect with current Utilization Review nurses or managers at Cone Health on LinkedIn; use ice breakers like commenting on recent healthcare initiatives at Cone Health or asking about their experiences with EPIC documentation and payer communications.
Optimize your resume for ATS by including keywords from the job description such as 'utilization review,' 'EPIC,' 'medical necessity,' 'authorization,' 'RN license,' and 'regulatory compliance' to ensure it passes initial screening.
Jennie Johnson's Power Apply can automate your applications across multiple platforms, tailor your resume for ATS, and identify LinkedIn contacts in the Utilization Review department, saving you time and increasing your chances of landing this role.
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