Director OF Utilization Management

To support efficient healthcare delivery, the contract Pennsylvania Licensed Utilization Manager will perform telephonic and onsite utilization reviews of hospital admissions, ensuring appropriate care levels and facilitating timely discharge planning in a remote capacity. Key Responsibilities Perform utilization management reviews for inpatient admissions via telephone or onsite Apply medical necessity criteria to determine inpatient admission status and appropriate length of stay Collaborate with hospital case management teams, physicians, and families to facilitate discharge to appropriate care settings Required Qualifications Active Pennsylvania RN License or Compact RN License required Minimum of 3 years of acute care clinical experience in a hospital or healthcare setting Post Acute experience required Prior discharge planning and/or utilization management experience preferred Residency in Pennsylvania, New Jersey, or Delaware is mandatory