RN Case Manager Utilization Review (Temple Hospital Jeanes Campus)
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Job Location:
Philadelphia, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
9 days ago
Vacancies:
1 Vacancy
Job Summary
Utilizing InterQual and other appropriate criteria responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospitals utilization management and quality assurance plan. Will determine the medical necessity for admission and continued stays for patients within departments scope of service and to meet the hospitals objectives for assuring a high quality of patient care as well as assuring the effective and efficient utilization of available health services. Identifies appropriate level of care for inpatients and outpatients requiring overnight care.
Education
Other Graduate of an accredited school of nursing Required
Bachelors Degree BSN Required
Experience
1 year experience of recent Utilization Review in acute care or in insurance company setting. Required
1 year experience in medical-surgical setting. Required
1 year experience in working with competency utilizing InterQual criteria. Required
General Experience in working with utilization review standards Required
Licenses
PA Registered Nurse License Required
Certified Case Manager Preferred
Multi State Compact RN License Required Or
Schedule: MondayFriday 8:00 AM4:30 PM with every 3rd weekend required
Your Tomorrow is Here!
TUH-Jeanes Campus in Northeast Philadelphia offers aunique combination: advanced medical and surgical services in a convenient easy-to-access community setting. A member of Temple Health TUH-JeanesCampus has many services that are typically only found at downtown hospitals including advanced cardiac neurologic and orthopedic surgery. TUH-Jeanes Campusexperienced doctors and dedicated staff offer patients access to many of the latest treatments and diagnostics while never losing sight of its commitment to providing a compassionate personal touch.
Your Tomorrow is Here!
Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH) Fox Chase Cancer Center TUH-Jeanes Campus TUH-Episcopal Campus TUH-Northeastern Campus Temple Physicians Inc. and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.
To support this mission Temple Health is continuously recruiting top talent to join its diverse 10000 strong workforce that fosters a healthy safe and productive environment for its patients visitors students and colleagues alike. At Temple Health your tomorrow is here!
Equal Opportunity Employer/Veterans/Disabled
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 or protected veteran status and will not be discriminated against on the basis of disability.
Required Experience:
Manager
Key Skills
- Project Portfolio Management
- Motivational Interviewing
- HIPAA
- Computer Skills
- Intake Experience
- Lean Six Sigma
- Conflict Management
- Case Management
- Team Management
- Program Development
- Social Work
- Addiction Counseling
About Company
Temple Health is a major Philadelphia-based academic health system that is driving medical advances through clinical innovation, pioneering research and world-class education.
