RN Utilization Management
Company: ChristianaCare
Location: Newark
Posted on: January 31, 2026
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Job Description:
ChristianaCare, a leading non-profit health system devoted to
improving the health of those we serve, is seeking a dedicated RN
in Utilization Management to join our team. This position is
pivotal in ensuring that all patient care provided meets the
essential criteria for appropriateness, quality, and efficiency, in
adherence to both healthcare standards and reimbursement
guidelines. As an RN in Utilization Management, you will work
collaboratively with healthcare providers and insurance companies
to ensure that patients receive timely, efficient, and medically
necessary services. Your role will involve reviewing patient cases,
discussing treatment plans, and ensuring compliance with healthcare
regulations. If you're passionate about upholding high standards in
healthcare and improving patient outcomes, we invite you to apply.
Conduct pre-admission, admission, and concurrent reviews of all
patients. Collaborate with healthcare providers to assess treatment
plans and healthcare needs. Liaise with insurance providers to
confirm coverage and understand benefits eligibility. Ensure
compliance with healthcare regulations and standards. Document all
case management activities and decisions. Identify opportunities
for care improvements and recommend solutions. Educate patients and
families about the care process and planning. Strong clinical
judgment and critical thinking skills. Exceptional communication
and interpersonal skills. Proficiency with healthcare IT systems.
Knowledge of healthcare laws, regulations, and standards. Ability
to multitask and manage time effectively. Medical Insurance Dental
Insurance Vision Insurance Life Insurance 401k Current RN licensure
in the state of Delaware. Certification in Case Management (CCM) or
similar preferred.
Keywords: ChristianaCare, Newark , RN Utilization Management, Healthcare , Newark, Delaware
