Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but that an authorization for services is obtained from payer, if required, and that documentation supports the care with minimal risk of denials. To provide leadership and oversight of the UR team. Coordinates insurance specific duties including CURP protocol. LPN or RN degree is required. Three years of previous nursing experience is required. **Benefits:** + Major medical, dental, vision, etc. + 401(k) + Paid time off + Tuition Reimbursement Grandview Medical Center, a 434-bed regional referral center and tertiary-care facility, is located in Birmingham, AL., and is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Grandview Medical Center offers programs and services in all medical and surgical areas, including Cardiology, Oncology, Neurology, Women's Health, Mental Health, Digestive Diseases, Orthopedics, Physical Medicine and Rehab, Sports Medicine and Emergency Care. There are more than 600 physicians on the Grandview medical staff representing 30 specialties and subspecialties. The hospital has been named an accredited program for Metabolic and Bariatric surgery by ASMBS & ACS as well as an accredited chest pain center. Grandview Medical Center provides equal employment opportunity to all employees and applicants for employment regardless of any individual’s race, color, religion, sex, sexual orientation, gender identity, national origin, age, citizenship, military status, disability, genetic information or any other protected class status in accordance with applicable federal, state, and local laws. At Grandview Medical Center, we believe in the power of great people and a team approach to make a difference in the health and well-being of the people and communities we serve. Compassion, a commitment to excellence, a safe environment, and opportunities for personal growth define ourculture. Whether you work with patients every day or support those who do, you can make an impact by being a part of our team. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.