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Mind Springs Health & West Springs Hospital is Hiring an Utilization Review Nurse Near Grand Junction, CO
Position QualificationsGraduate from an accredited school of Nursing and licensed as a Registered Nurse in the State of Colorado. Two (2) years previous experience in a psychiatric hospital or other psychiatric setting preferred. Experience in utilization review with insurance companies/payers preferred. Background in an inpatient, emergency room, or family practice setting desirable.
Job PurposePerform concurrent reviews to justify continued hospitalization, ensuring all services will be reimbursed and the quality of services provided align with organizational standards and applicable regulations for inpatient psychiatric hospitals.
Knowledge, Skill & Ability(include Materials And Equipment Directly Used)
- CPR/BLS Certification for Healthcare Provider optional.
- Verbal De-Escalation/Certification optional in order to perform duties required to provide verbal de-escalation and physical and mechanical restraints if necessary (Training for certification will be provided).
- Ability to accurately collect and analyze data and report on significant utilization trends and identify areas for improvement.
- Ability to review chart content, screening for rationale to justify hospitalization.
- Working knowledge of psychiatric medications, their efficacy, rationale for medications
- Ability to assess individual's potential for dangerousness to self, to others and/or grave disability.
- Ability to collaborate and communicate successfully with hospital staff and external customers.
- Ability to work closely with treatment team and providers to obtain necessary clinical information.
- Ability to advocate for patients and their right to receive care which is reimbursed for appropriately.
- Ability to appropriately and immediately document interactions with patients and potential patients.
- Maintain the confidentiality of all patient information per HIPAA regulations, federal and state law, and facility policies and procedures.
- Working knowledge of Windows based computer applications to include Microsoft Word, Microsoft Excel, Microsoft Outlook, and Internet access.
- Ability to operate standard office equipment including calculator, copy machine, fax and multi-line telephone.
- Interpersonal and communication skills to develop and maintain effective working relationships with all internal and external customers.
- Ability to organize and prioritize workload in a sometimes hectic environment with frequent interruptions.
Job Summary
Full Time
$80k-99k (estimate)
05/20/2024
06/16/2024
mindspringshealth.org
Grand Junction, IA
200 - 500
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The job skills required for Utilization Review Nurse include CPR, Psychiatric, Communication Skills, Confidentiality, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Nurse. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Nurse. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Nurse positions, which can be used as a reference in future career path planning. As an Utilization Review Nurse, it can be promoted into senior positions as a Clinical Outcomes Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Nurse. You can explore the career advancement for an Utilization Review Nurse below and select your interested title to get hiring information.
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