Registered Nurse- UR Manager, Central Utilization Review- Full Time, Days, 8 AM - 4 PM, Morristown NJ
Atlantic Health System
- Morristown, NJ
- 30+ days ago
Highlights
Partner with physician advisors and care teams on level-of-care questions, peer-to-peer reviews, potential account downgrades, and clinical appeals. Identify recurring payer and Independent Review Organization issues and share findings with Managed Care Contracting and appeals leadership.
Numbers & Facts
| Location | Morristown, NJ |
Description
JobID: 32706
Category: Qual, Patient Safety& Inf Prev
JobSchedule: Full-Time
Posted Date: 2026-09-16T22:17:19+00:00
JobShift:
Minimum Salary (Hourly Rate): 61.180000
Key responsibilities
- Lead, coach, and support the Central UR nurses and Insurance Specialists; manage assignments, workflow priorities, and staff performance.
- Ensure timely initial and continued-stay reviews, authorization follow-up, payer communication, and escalation of cases at risk for denial.
- Partner with physician advisors and care teams on level-of-care questions, peer-to-peer reviews, potential account downgrades, and clinical appeals.
- Analyze denial, appeal, authorization, and UR performance data to identify trends and lead corrective action.
- Work with hospital case management, medical, nursing, and revenue cycle leaders to resolve barriers and improve care progression.
- Identify recurring payer and Independent Review Organization issues and share findings with Managed Care Contracting and appeals leadership.
- Develop clear workflows, education, and tools in response to performance gaps, payer requirements, and regulatory changes.
- Monitor improvement plans and help teams sustain results across AHS hospitals.