CASE MGMT - UTILIZATION REVIEW RN (Newark,DE)

Company: Beebe Healthcare
Location: Newark
Posted on: February 19, 2021

Job Description:

Summary:
A Registered Nurse responsible for working collaboratively with the medical staff and other health care disciplines to facilitate patient care throughout the continuum. The case manager will assume a leadership position within the department to direct and coordinate patient care by avoiding duplication and misuse of medical services. The case manager is required to maintain and support the standards of patient care.

Other information:
Three to five years clinical experience.Previous experience in Case Management including knowledge of Interqual criteria and Utilization Management preferred.Skills include the 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.

Responsibilities:
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. Displays leadership in promoting corporate integrity. 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 soft ware.

Credentials:
Essential:
* RN - Registered Nurse

Competencies and skills:
Essential:
* Clear Communication Skills Both Written And Verbal
* Able To Keep Confidential Information Regarding Patients, Team Members
* Able To Withstand Crisis Situations
* Has Skills To Provides Customer Service To Patients, Team Members And Visitors
* Knowledge And Experience With Electronic Health Records
* Experience With Excel, Power Point, Word, Visio, Etc.

Education:
Essential:
* RN Diploma/RN Graduate Program

Location: Hospital-Main Campus

Shift :

FTE: 1.000000

Work Status: Full Time Associated topics: care unit, ccu, intensive care, nurse clinical, nurse rn, psychatric, staff nurse, surgery, surgical, unit

Keywords: Beebe Healthcare, Newark , CASE MGMT - UTILIZATION REVIEW RN (Newark,DE), Healthcare , Newark, Delaware