The Utilization Management Nurse reports directly to Utilization Review RN Coordinator. The UR Nurse supports the UR RN Coordinator in providing oversight and guidance to all utilization functions for the organization and is responsible for ensuring complaint utilization and cost-effective care delivery. The UR Nurse is responsible for tracking and monitoring the level of care from the ED through discharge and follows and addresses denials to assess effectiveness of documentation and billing practices from a utilization perspective. In collaboration with the patient/family, physicians, and the interdisciplinary team, the UR Nurse ensures the care delivery systems in place at SPH are utilized effectively and efficiently and engages the UR RN Coordinator with improvement ideas when deviations of best practice are noted. The UR Nurse serves as an advocate for the patient and family throughout the continuum of care and serves as a collaborative and supportive liaison and educator to providers and staff around utilization management principles.