Elevate your career at Wood County Hospital

Where you're not just a number – you're a vital part of a team making a real difference.

Utilization Review Registered Nurse/ Discharge Planning / Per Diem

The Discharge Planning Nurse is responsible for coordinating safe, timely, and effective patient transitions from the hospital to the next level of care. This role works collaboratively with physicians, social workers, nursing staff, patients, and families to assess discharge needs, develop individualized discharge plans, and ensure continuity of care.

Essential Functions

• Review clinical documentation to determine medical necessity, level of care, and continued stay appropriateness in accordance with established criteria, payer requirements, and regulatory standards.
• Collaborate with physicians, nursing, case management, social work, and interdisciplinary teams to support timely care progression, discharge planning, and effective transitions of care.
• Communicate utilization review findings, authorization requirements, and coverage determinations to providers, payers, and internal stakeholders in a clear and timely manner.
• Document utilization review activities, decisions, and outcomes accurately within the medical record and designated utilization management systems to ensure compliance and audit readiness.
• Monitor and support compliance with federal, state, accreditation, and payer regulations by identifying utilization trends, participating in quality improvement initiatives, and assisting with audits and surveys.
• Prepare, prevent, protect, and respond to support our culture of safety.
• Works hours per week in accordance with offer letter or per attributes of position at transfer request. May be expected to work longer hours as necessary.
• Other duties as assigned.