What are the responsibilities and job description for the Utilization Review Nurse - Care Coordination Services position at Montage Health?
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Job Description:
Under the leadership of the department director the Utilization Review Nurse facilitates quality care by screening the admission and continued stay of patients utilizing Intensity of Service/Severity of Illness criteria. The Utilization Nurse complies with regulatory requirements and supports systems and processes to meet regulations. Important dimensions of this position consist of quality, professional commitment, teamwork, interpersonal skills, safety, good public/customer relations and a broad clinical knowledge.
Experience
Must have 5 years current acute care hospital experience. Broad clinical expertise to evaluate patient diagnosis and treatment plan and outcomes utilizing established criteria. Effective communication and public relations skills. Ability to work as an integral member of the interdisciplinary assessment team. Strong organization skills. Knowledge of financial reimbursement — state, federal and commercial insurance requirements preferred. Knowledge of Government programs, rules and regulations, and commercial insurance requirements preferred.
Education
Bachelor’s degree in nursing preferred.
Licensure/Certifications
State of California RN license required.
Equal Opportunity Employer
Assigned Work Hours:
Full time (On-site)
Position Type:
Regular
Pay Range (based on years of applicable experience):
$71.69
to
$95.88
The hours employees work determine when a shift differential is paid.
Hourly Evening Shift Differential: $5.50
Hourly Night Shift Differential: $8.00
Job Description:
Under the leadership of the department director the Utilization Review Nurse facilitates quality care by screening the admission and continued stay of patients utilizing Intensity of Service/Severity of Illness criteria. The Utilization Nurse complies with regulatory requirements and supports systems and processes to meet regulations. Important dimensions of this position consist of quality, professional commitment, teamwork, interpersonal skills, safety, good public/customer relations and a broad clinical knowledge.
Experience
Must have 5 years current acute care hospital experience. Broad clinical expertise to evaluate patient diagnosis and treatment plan and outcomes utilizing established criteria. Effective communication and public relations skills. Ability to work as an integral member of the interdisciplinary assessment team. Strong organization skills. Knowledge of financial reimbursement — state, federal and commercial insurance requirements preferred. Knowledge of Government programs, rules and regulations, and commercial insurance requirements preferred.
Education
Bachelor’s degree in nursing preferred.
Licensure/Certifications
State of California RN license required.
Equal Opportunity Employer
Assigned Work Hours:
Full time (On-site)
Position Type:
Regular
Pay Range (based on years of applicable experience):
$71.69
to
$95.88
The hours employees work determine when a shift differential is paid.
Hourly Evening Shift Differential: $5.50
Hourly Night Shift Differential: $8.00
Salary : $72 - $96