Utilization Review RN
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Job Summary
Job Details
Job Location: Trinity Health Hospital Campus & Medical District - Minot ND
Position Type: Part Time
Salary Range: $38.27 - $59.32 Hourly
Job Shift: Days
Job Category: Nursing
Description
The UR RN Case Manager facilitates effective utilization of appropriate health services via collaboration with physicians nurses social workers other healthcare team members (ie - financial counselors) and payers to coordinate health care services that optimize clinical outcomes and patient satisfaction with services from pre-admission through post-discharge transition for this select patient population for all portals of entry. This position performs pre-admission concurrent admission and retrospective clinical review of medical necessity to determine the appropriate level of care and resource utilization. The UR RN Case Manager is responsible for ensuring implementation and monitoring of compliant documentation strategies by ensuring procedure(s) noted in the pre-admission review was/were completed and the physicians orders are present accurate and signed before patient being discharged; or updated as needed once the operative note has been reviewed.
Benefits:
Health Vision and Dental.
HSA or HSA
Life insurance
401K
PTO and Sick leave
Employee referral program
Qualifications
Licenses and Certifications Required:
Current or temporary RN license in ND or compact RN licensure. BLS certification is required within the orientation period.
Educational Requirements:
BSN preferred.
Experience Requirements:
Must have three (3) years of recent experience in a clinical area. Prior Case Management/Utilization Review experience preferred.
Special Skills or Training Requirements:
Demonstrated evidence of dependability diplomacy and initiative. Demonstrated strong communication and interpersonal skills with all levels of internal and external customers including but not limited to medical staff patients and families clinical personnel other Case Managers support and technical staff outside agencies third party payers and members of the community: Basic understanding of reimbursement issues denials and DRGs: Knowledge of clinical criteria for medical necessity: Personal computer skills using e-mail and Microsoft Office Suite.
Job Location: Trinity Health Hospital Campus & Medical District - Minot ND
Position Type: Part Time
Salary Range: $38.27 - $59.32 Hourly
Job Shift: Days
Job Category: Nursing
Description
The UR RN Case Manager facilitates effective utilization of appropriate health services via collaboration with physicians nurses social workers other healthcare team members (ie - financial counselors) and payers to coordinate health care services that optimize clinical outcomes and patient satisfaction with services from pre-admission through post-discharge transition for this select patient population for all portals of entry. This position performs pre-admission concurrent admission and retrospective clinical review of medical necessity to determine the appropriate level of care and resource utilization. The UR RN Case Manager is responsible for ensuring implementation and monitoring of compliant documentation strategies by ensuring procedure(s) noted in the pre-admission review was/were completed and the physicians orders are present accurate and signed before patient being discharged; or updated as needed once the operative note has been reviewed.
Benefits:
Health Vision and Dental.
HSA or HSA
Life insurance
401K
PTO and Sick leave
Employee referral program
Qualifications
Licenses and Certifications Required:
Current or temporary RN license in ND or compact RN licensure. BLS certification is required within the orientation period.
Educational Requirements:
BSN preferred.
Experience Requirements:
Must have three (3) years of recent experience in a clinical area. Prior Case Management/Utilization Review experience preferred.
Special Skills or Training Requirements:
Demonstrated evidence of dependability diplomacy and initiative. Demonstrated strong communication and interpersonal skills with all levels of internal and external customers including but not limited to medical staff patients and families clinical personnel other Case Managers support and technical staff outside agencies third party payers and members of the community: Basic understanding of reimbursement issues denials and DRGs: Knowledge of clinical criteria for medical necessity: Personal computer skills using e-mail and Microsoft Office Suite.
About Company
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more
