RN - Utilization Review
Pride Health is hiring for a Rn-Utilization Review in Lewes, DE! (Permanent position)Type:
Full time or part time are available Schedule :
M-F (2pm-10:
30pm) Rotating weekends Salary Range :
$75-115k Job Duties:
Works to resolve questionable Utilization cases.
Knowledge of InterQual criteria and appropriate levels of care.
Promotes internal and external understanding of Utilization Management.
Maintains familiarity with laws, regulations and their interpretations affecting utilization management processes and UM nurse role at BMC.
Follows procedure to issue Hospital Issued Notices of Noncoverage (HINN) notices when appropriate.
Leads the treatment team in understanding, monitoring and effective utilization of hospital resources.
Monitors for compliance to Federal, State and JC requirements.
Takes action when deficiencies are found.
Computer Skills/ Allscripts/ Invision/Document Imaging.
Documentation competency, skill, and accuracy in entering data into Allscripts software.
Benefits - Health Insurance is available to team members on the first of the month after completing 30 days of employment all other benefits start on the first of the month after completing 90 days of employment.
Required
Qualifications:
Three to five years clinical experience.
Previous experience in Case Management including knowledge of Interqual criteria and Utilization Management- Preferred.
Ability to review cases for appropriate level of care for admission, continued stay and the utilization of discharge screens.
Possess strong communication, problem solving and organizational skills.
Must be proficient in word processing and the use of clinical software.
Apply for this role with Pride Health! #CB Rate/Salary:
Recommended Skills Case Management Clinical Works Communication Coordinating Document Imaging In Vision Estimated Salary: $20 to $28 per hour based on qualifications.
Full time or part time are available Schedule :
M-F (2pm-10:
30pm) Rotating weekends Salary Range :
$75-115k Job Duties:
Works to resolve questionable Utilization cases.
Knowledge of InterQual criteria and appropriate levels of care.
Promotes internal and external understanding of Utilization Management.
Maintains familiarity with laws, regulations and their interpretations affecting utilization management processes and UM nurse role at BMC.
Follows procedure to issue Hospital Issued Notices of Noncoverage (HINN) notices when appropriate.
Leads the treatment team in understanding, monitoring and effective utilization of hospital resources.
Monitors for compliance to Federal, State and JC requirements.
Takes action when deficiencies are found.
Computer Skills/ Allscripts/ Invision/Document Imaging.
Documentation competency, skill, and accuracy in entering data into Allscripts software.
Benefits - Health Insurance is available to team members on the first of the month after completing 30 days of employment all other benefits start on the first of the month after completing 90 days of employment.
Required
Qualifications:
Three to five years clinical experience.
Previous experience in Case Management including knowledge of Interqual criteria and Utilization Management- Preferred.
Ability to review cases for appropriate level of care for admission, continued stay and the utilization of discharge screens.
Possess strong communication, problem solving and organizational skills.
Must be proficient in word processing and the use of clinical software.
Apply for this role with Pride Health! #CB Rate/Salary:
Recommended Skills Case Management Clinical Works Communication Coordinating Document Imaging In Vision Estimated Salary: $20 to $28 per hour based on qualifications.
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