What are the responsibilities and job description for the Utilization Review RN / Utilization Review / PRN Weekends position at Catawba Valley Health System?
JOB DESCRIPTION
Summary of Performance Expectations
Manages the utilization review process for assigned patients. Assesses the appropriateness of admission and treatment plans based upon clinical norms and judgment. Participates in a unified program of concurrent and retrospective monitoring of factors contributing to efficient utilization of hospital resources to provide quality patient care in the most cost effective manner possible. Balances fiscal benefits for the patient with fiscal restraints for the organization that may be imposed by regulatory agencies. Advocates for patients and intercedes as necessary to accomplish these goals. Provides education to the patient, patient’s family/significant others, physicians, administration, and hospital staff related to the utilization review.
Education And Credentials:
Required:
Work Experience:
Required:
Three years of previous nursing experience. Given training and on-the-job experience, incumbent should be proficient in the basic aspects of the job within three months of employment date.
Preferred:
Two years discharge planning, utilization review, or case management experience.
ABOUT US
About Catawba Valley Medical Center
COMPREHENSIVE, ACCESSIBLE HEALTHCARE SERVICES IN THE CATAWBA VALLEY
As the region’s largest not-for-profit community hospital, we exist to heal and comfort patients, to promote and foster a healthier community, and to ensure access to healthcare to all who need it - regardless of ability to pay. With a wide array of medical specialties, our skilled nurses and providers are trained to treat virtually any type of injury or illness, providing high-quality, easily accessible healthcare close to home.
Our mission: Exceptional Healthcare. Every Person. Every Time.
At A Glance:
Catawba Valley Medical Center offers a wide range of services from experienced medical specialists capable of addressing virtually any healthcare concern. Our current hospital holds 258 beds and serves the five-county Hickory area. Through our skilled medical practitioners and our highly trained staff, we strive to provide the highest level of medical expertise using the latest, state-of-the-art technology available.
One of our goals at Catawba Valley Medica Center is to provide seamless care between your primary care provider and our hospital. Being a part of a vast healthcare network allows for easier and more efficient communication between local physicians, medical specialists and our hospital. No one should have to travel far for the expert level medical treatment they need. We work with a plethora of medical specialists capable of diagnosing, treating and operating on a wide variety of conditions.
Summary of Performance Expectations
Manages the utilization review process for assigned patients. Assesses the appropriateness of admission and treatment plans based upon clinical norms and judgment. Participates in a unified program of concurrent and retrospective monitoring of factors contributing to efficient utilization of hospital resources to provide quality patient care in the most cost effective manner possible. Balances fiscal benefits for the patient with fiscal restraints for the organization that may be imposed by regulatory agencies. Advocates for patients and intercedes as necessary to accomplish these goals. Provides education to the patient, patient’s family/significant others, physicians, administration, and hospital staff related to the utilization review.
Education And Credentials:
Required:
- Graduate of accredited nursing program.
- Current NC RN license or licensure from Nursing Compact State.
- BCLS certification. If the BCLS certification is not from the American Heart Association (AHA), an AHA certification is required within three months of employment date.
- Effective May 4, 2015 newly employed Registered Nurses and current employees promoted to Registered Nurse positions are required to possess a BSN or higher nursing degree.
- The BSN or higher nursing degree must be completed within five years from the date of employment or placement into the RN position.
- Incumbents in CVMC RN positions on the effective date will not be required to satisfy the BSN degree requirement to maintain their current position, be promoted to a charge nurse or Operating Room specialty RN position, or apply for lateral RN positions in another CVMC department. Exception: RNs transferring to the IRT department are subject to the BSN requirement.
- RNs employed in positions at Catawba Valley Medical Group (CVMG), Fairgrove Primary Health and Catawba Valley Infectious Disease are exempt from this requirement.
Work Experience:
Required:
Three years of previous nursing experience. Given training and on-the-job experience, incumbent should be proficient in the basic aspects of the job within three months of employment date.
Preferred:
Two years discharge planning, utilization review, or case management experience.
ABOUT US
About Catawba Valley Medical Center
COMPREHENSIVE, ACCESSIBLE HEALTHCARE SERVICES IN THE CATAWBA VALLEY
As the region’s largest not-for-profit community hospital, we exist to heal and comfort patients, to promote and foster a healthier community, and to ensure access to healthcare to all who need it - regardless of ability to pay. With a wide array of medical specialties, our skilled nurses and providers are trained to treat virtually any type of injury or illness, providing high-quality, easily accessible healthcare close to home.
Our mission: Exceptional Healthcare. Every Person. Every Time.
At A Glance:
- North Carolina’s first and only 5-time Magnet recipient for nursing excellence
- Region’s only level III Neonatal Intensive Care Unit (NICU)
- Women’s Choice Award winner for America’s Best 100 Hospitals for Patient Experience for six consecutive years
- American College of Surgeons Accredited Comprehensive Community Cancer Center
Catawba Valley Medical Center offers a wide range of services from experienced medical specialists capable of addressing virtually any healthcare concern. Our current hospital holds 258 beds and serves the five-county Hickory area. Through our skilled medical practitioners and our highly trained staff, we strive to provide the highest level of medical expertise using the latest, state-of-the-art technology available.
One of our goals at Catawba Valley Medica Center is to provide seamless care between your primary care provider and our hospital. Being a part of a vast healthcare network allows for easier and more efficient communication between local physicians, medical specialists and our hospital. No one should have to travel far for the expert level medical treatment they need. We work with a plethora of medical specialists capable of diagnosing, treating and operating on a wide variety of conditions.
