Elliot health system - rn utilization review - care coordination - per diem | Ukiah, CA

Detailed Information

  • Location: Manchester, CA

strong clinical experience/skills, please consider our department! We will do on the job training for experienced Nurses who meet the requirements below! Apply today! About the Job: The Utilization Review RNs (UR RN) primary responsibility is to monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services.

The Utilization Review RN will utilize medical necessity screening tools, such as Inter Qual, to complete admission reviews in determining appropriate level of care; and will document continued stay reviews for continued need for inpatient care, appropriateness of tests and procedures, and an estimation of the patient's expected

length of stay. And more. What You'll Do: Screens all patients admitted to Elliot Hospital either on admission or next business day to determine the appropriate level of care Identifies and monitors observation status patients concurrently to ensure appropriate utilization of observation status Performs concurrent reviews for patients to ensure that extended stays are medically justified Refers to the Utilization Review Physician Advisor cases that do not meet established guidelines for admission or continued stay Obtains timely insurance authorization/certifications from all payers requiring authorization of hospitalizations, test, procedures, medications, etc Maintains knowledge of current

Federal, State and payer regulatory requirements pertinent to utilization review processes Who You Are: Bachelor's degree in a healthcare-related field or equivalent experience Current BSN or commitment to achieving the degree in a specified amount of time A minimum of three (3) years hospital case management or utilization management experience , Required.

CCM or ACM preferred Excellent clinical documentation, and successful usage of EMR systems, Preferred Why You'll Love Us: Health, dental, prescription, and vision coverage for full-time & part-time employees Short term, long term disability, Accident insurance, & life insurance Tuition Reimbursement Referral bonuses Accrued earned time for full-time & part-time employees403b Retirement plans, with generous employer contributions And more!

#CRM Work Shift: Per Diem - Varied Solution Health is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, interactionual orientation, disability status, veteran status, or any other characteristic protected by law. For more details: jobs-search. org/information-technology_manchester-c425504/elliot-health-system-rn-utilization-review-care-coordination-per-diem-manchester_i1949214024

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