Utilization Management RN presso EvergreenHealth
EvergreenHealth · Kirkland, Stati Uniti d'America · Onsite
- Professional
- Ufficio in Kirkland
Wage Range: $47.70 - $76.31 per hour
Candidates must live in WA state. Role will need to be on Kirkland campus for initial training and orientation.
Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.
EvergreenHealth is seeking an experienced RN to join the Care Management Team. Come join the team, where we consistently earn top honors for patient care and continually look for new and innovative ways to improve.
Job Summary:
The RN in our Care Management department specializes in assessing hospital admissions for status per defined criteria and reviews for appropriate utilization of resources. Ensures continuity and coordination of care for patients before, during and after hospitalization, and ensures that payer conditions are met. In conjunction with the interdisciplinary team supervises progress and recommends appropriate clinical interventions to nursing staff and attending physicians, ensuring CMS guidelines are met. In conjunction with the interdisciplinary team ensures that patients and families have access to resources for post-hospital care needs.
The RN in our Care Management department specializes in assessing hospital admissions for status per defined criteria and reviews for appropriate utilization of resources. Ensures continuity and coordination of care for patients before, during and after hospitalization, and ensures that payer conditions are met. In conjunction with the interdisciplinary team supervises progress and recommends appropriate clinical interventions to nursing staff and attending physicians, ensuring CMS guidelines are met. In conjunction with the interdisciplinary team ensures that patients and families have access to resources for post-hospital care needs.
- Monitors patients’ medical progress, identifies and addresses patient needs/gaps in service as they move through the system, and obtains authorization for discharge planning as appropriate. Takes action to correct variances in length of stay by following up with physicians and payers as needed.
- Provides utilization reviews, meeting all time requirements and addresses the discharge appeal process in collaboration with the physician, Dir/Mgr and/or Social Worker
- Performs other duties as assigned.
License, Certification, Education or Experience:
REQUIRED for the position:
- Current State of Washington RN license
- Bachelors of Science degree in Nursing or be actively pursuing a degree in Nursing
- Three (3) years of experience as an RN with a combination of acute care and/or case management experience.
- Current American Heart Association Healthcare Provider BLS certification by date of hire.
- Knowledge of the healthcare financial environment, reimbursement and levels of care.
- Knowledge of community resources and how to access them effectively and efficiently.
- Interpersonal skills necessary to lead and coordinate an interdisciplinary team and deal effectively with patients and families from a variety of backgrounds and with varied emotional and medical needs.
- Age-appropriate developmental assessment skills.
- Excellent communication skills to ensure and deliver safe patient care and to provide a legal record of this care.
- Accountability for professional nursing practice, commitment to patient care and commitment to uphold the Patient Bill of Rights.
DESIRED for the position:
- Master’s degree in Nursing or other experience and /or educational preparation that would provide the foundation for Nursing Case Management
Benefit Information:
Choices that care for you and your family
Choices that care for you and your family
At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer the following benefits and resources for our per diem staff to help maintain and improve health and financial well-being.
- Medical, vision and dental insurance
- On-demand virtual health care
- Health Savings Account
- Flexible Spending Account
- Life and disability insurance
- Retirement plans (457(b) and 401(a) with employer contribution)
- Tuition assistance for undergraduate and graduate degrees
- Federal Public Service Loan Forgiveness program
- Paid Time Off/Vacation
- Extended Illness Bank/Sick Leave
- Paid holidays
- Voluntary hospital indemnity insurance
- Voluntary identity theft protection
- Voluntary legal insurance
- Pay in lieu of benefits premium program
- Free parking
- Commuter benefits
