RN Utilization Manager
RN Utilization Manager
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Weve made a lot of progress since opening the doors in 1942 but one thing has never changed our commitment to serve heal lead educate that every award earned every record broken and every patient helped is because of the dedicated employees who fill our hallways.
At Ochsner whether you work with patients every day or support those who do you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!
This job is a registered Nurse with a diverse medical background who is able to determine the psychosocial environmental family economic dynamics that may affect the patient. This job confirms a clear specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions levels of care and continued stay. Documents completed reviews in the hospital approved data set and discusses when appropriate alternative care options with the ED Admitting or Attending Physician. Functions as the liaison and communicator with the patient caregivers multidisciplinary team members as well as postacute care and third party payers.To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.
This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or allinclusive listing of duties and responsibilities. Contents are subject to change at the companys discretion.
Education
Required Registered Nurse Diploma or equivalent
Work Experience
Required 1 year ofHospital based experience in the delivery of patient care.
Experience functioning independently and working well within a team setting.
Experience responding to change positively and working calmly as well as efficiently in high pressure situations.
Preferred Experience in Case Management or Utilization Review
Business and Financial Knowledge as well as understanding of Health Care Delivery Systems
Certifications
RequiredCurrent RN License in the state of practice.
Knowledge Skills and Abilities (KSAs)
- Must have computer skills and dexterity required for data entry and retrieval of patient information.
- Must be proficient with Windowsstyle applications and keyboard.
- Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
- Excellent conflict resolution skills
- Ability to respond to change positively and work calmly as well as efficiently in high pressure situations.
- Ability to functionindependently and work well within a team setting.
- Sense of objectivity strong ethical principles professionalism sense of humor strong work ethic energy and creativity
Job Duties
Supports the values of Service Excellence Teamwork and Integrity. Maintains minimum standards for licensure and strives for professional /personal development.
Performs PreAdmission Admission and Continued Stay activities
Maintains open communication with all appropriate parties.
Manages aspects of the planning process in anticipation of the patients movement through the healthcare system.
Proactively interacts with managed care/ third party payers to obtain financial certification to appropriate reimbursement and minimize reimbursement denials.
Manages the care of assigned patients through the healthcare system based on the patients individual needs.
- Additional duties as assigned.
Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities duties and skills. Other duties may be added or this description amended at any time.
Remains knowledgeable on current federal state and local laws accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws regulations and standards.
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety patient privacy and/or other compliancerelated concerns.
The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin protected veteran status or disability status.
Physical and Environmental Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Light Work Exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount a job should be rated Light Work: 1 when it requires walking or standing to a significant degree; or 2 when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or 3 when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace especially in an industrial setting can be and is physically demanding of a worker even though the amount of force exerted is negligible.
Mechanical lifting devices (carts dollies etc. or team lifts should be utilized.
Must be able to stoop bend reach and grab with arms and hands manual dexterity.
Must be able to sit for prolonged periods of time.
Must be able to work a flexible schedule (e.g. 24/7 weekend holiday on call availability).
Duties performed may require exposure to blood body fluid and tissue.
The incumbent works in a patient care area; works in an area where patients enter; works directly with patients; and/or works with specimens that could contain diseases. There may be an occupational risk for exposure to all communicable diseases.
Because the incumbent works within a healthcare setting there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt transport storage preparation dispensing administration cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
Are you ready to make a difference Apply Today!
Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.
Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado California Hawaii Illinois Maryland Minnesota New York Washington and Washington D.C.
Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website or if you need an accommodation to complete the application process please contact our HR Employee Solution Center at(select option 1 or. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.
Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class including protected veterans and individuals with disabilities.
Required Experience:
Manager
Employment Type
Full-Time
