Utilization Manager RN

The Utilization Review Nurse (Emergency Department Utilization Care Manager) at Brown University Health oversees medical necessity review of patient care records and coordinates with physicians and payers to obtain appropriate authorizations and notices. The role supports regulatory compliance and patient throughput while promoting safe, high-quality, and fiscally responsible care. It operates within the hospital setting and interfaces with clinical teams, third-party payers, and patients regarding coverage and appeals.