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1 Utilization Review Nurse Job in Kalamazoo, MI

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NeuroPsychiatric Hospitals
Kalamazoo, MI | Full Time
$79k-98k (estimate)
2 Months Ago
Utilization Review Nurse
$79k-98k (estimate)
Full Time | Hospital 2 Months Ago
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NeuroPsychiatric Hospitals is Hiring an Utilization Review Nurse Near Kalamazoo, MI

About Us

HEALING THE BODY AND MIND 

Founded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical needs. We are unique in that we serve a population which others have been previously been unable to, largely due the patient’s underlying medial issues. Our facilities maintain an inter-disciplinary focus using a multi-specialty approach for both neuropsychiatric and complex medical care issues. This proven approach provides unrivaled quality care for all of our patients. We have multiple locations throughout the United States and are continuing to add locations to ensure better access to our unique model of care. 

Overview

Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams. This will provide service to our utilization review team at our brand new hospital in Kalamazoo, Michican! 

Benefits of joining NPH

  • Competitive pay rates
  • Medical, Dental, and Vision Insurance
  • NPH 401(k) plan with up to 4% Company match
  • Employee Assistance Program (EAP) Programs
  • Generous PTO and Time Off Policy
  • Special tuition offers through Capella University
  • Work/life balance with great professional growth opportunities
  • Employee Discounts through LifeMart

Responsibilities

  • Filing documents as needed.
  • Initial Precertification with payors.
  • Concurrent Clinical review with payors.
  • Document in the electronic system daily in real time.
  • Admission audit.
  • Ensures that CON’s/RON’s and CMS certifications are completed by provider.
  • Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
  • Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
  • Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
  • Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
  • Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
  • Complies with hospital expectations regarding ethical behavior and standards of conduct.
  • Complies with federal and hospital requirements in the areas of protected health information and patient information.
  • Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
  • Provides education to nursing staff. leadership team, and providers regarding documentation.
  • Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.

Qualifications

Education: Must have graduated from an accredited school of nursing.

Licensure: Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the state of required

Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Hospital

SALARY

$79k-98k (estimate)

POST DATE

03/20/2024

EXPIRATION DATE

03/19/2025

WEBSITE

neuropsychiatrichospitals.net

HEADQUARTERS

MISHAWAKA, IN

SIZE

25 - 50

FOUNDED

2006

CEO

CAMERON GILBERT

REVENUE

$50M - $200M

INDUSTRY

Hospital

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About NeuroPsychiatric Hospitals

To make a referral, please call our referral hotline: 1-877-398-4186 IF THIS IS AN EMERGENCY, PLEASE DIAL 911 OR GO TO THE NEAREST EMERGENCY ROOM On behalf of our psychiatric, medical and professional staff, we would like to personally welcome you to NeuroPsychiatric Hospitals (NPH), a new and innovative care model offered in Northern and Central Indiana. NPH is a system of acute, inpatient hospitals with an innovative approach to neuropsychiatric care for the geriatric and adult population. Unlike hospitals who are solely psychiatric-based, NPH utilizes an interdisciplinary team of psychiatri...sts, psychologists, neurologists and medical doctors. This team works collaboratively to evaluate chronic behavioral and emotional disorders that may have a psychiatric, neurological or medical pathogenesis. This model was borne out of the desire to provide the most comprehensive care possible to adult and geriatric patients with compromised cognitive or behavioral statuses who are also often medically and/or neurologically compromised. Many of our patients have been in and out of other acute settings, being continually treated for the symptomatology without a thorough understanding of the etiology. This population can experience metabolic changes, synergistic reactions due to polypharmacy, and have multiple underlying medical diagnoses that cause and/or exacerbate cognitive and behavioral issues. It is for that reason that NPH is intentionally thorough with each patient, often requiring more intensive and specialized services and greater time to reconstitute than seen in typical acute care settings. We strive to heal both the body and the mind. We have hospitals in Mishawaka, IN, Bremen, IN and Indianapolis, IN. We are currently developing a location in Northwest Indiana which we expect to open in early 2016. . More
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