Primary Location Lanham-Seabrook, Maryland
Job Number 1195006
Description:
The Utilization Review RN is responsible for utilization review, discharge planning and transitions in care, in collaboration with MAPMG rounder in acute or alternative settings of care.
- Utilization Review. According to department policy, procedure and protocols, consistently apply and verbally communicate approved utilization review criteria and guidelines for services delivered in acute or alternative care settings.
- Eligibility and Benefit Verification. Confirm eligibility status and ensure the appropriate administration of benefits in accordance with department policies and procedures.
- Assessing Right Venue of Care with Hospitalist. Collaboration with Hospitalist to assess the appropriate level of care for patients (i.e., Medical Unit, Surgical Unit, Tele Unit, TCU, ICU) and post- (Home, Continuum or Community-based Services) hospitalization.
- Coordination of Care. Driving patient care plan through assuring daily plan is executed, and management of transitions and post-hospital care.
- Effective Discharge Planning. Prompt, clinically appropriate discharge planning beginning at time of admission.
- Variance Management. Timely steps in identification of delays in throughput, escalation to correct delays, and recording delays to identify patterns and trends that will require corrective actions.
- Quality Screening. Demonstrate competency to assess all aspects of care across the continuum for variations from quality and utilization standards.
- Performs other related duties as directed.
- Minimum one (1) year of experience as an RN in an acute care setting.
- N/A
- This job requires credentials from multiple states. Credentials from the primary work state are required before hire. Additional Credentials from the secondary work state(s) are required post hire.
- Registered Nurse License (Virginia) within 6 months of hire AND Registered Nurse License (Maryland) within 6 months of hire
OR
- Compact License: Registered Nurse within 6 months of hire
- Registered Nurse License (District of Columbia) within 6 months of hire
- Basic Life Support
- Annually: Successful completion of PCC Assessment of Critical Skills. Passing score on inter-rater reliability.
- Ability to effectively communicate.
- Ability to conform to established policies and procedures.
- Ability to analytically problem solve and make decisions.
- Ability to tolerate and cope with ambiguity
- Ability to work as a team member.
- Proficiency in the use of applicable computer software.
- Demonstrated ability to effectively and clearly present information through the written word, to influence or persuade others through oral presentation in positive or negative circumstances, and to listen well.
- Demonstrated ability to write clearly, legibly, and effectively, to present ideas and document activities, to read and interpret written information.
- Recent acute care, case management, or home health experience preferred.
- B.S.N. preferred.
Primary Location: Maryland,Lanham,Doctors Community Hospital 8200 Good Luck Rd..
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun
Working Hours Start: 08:30 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Employee Status: Regular
Employee Group/Union Affiliation: M38|UFCW|Local 400
Job Level: Individual Contributor
Department: Doctors Community Hospital – UR-Discharge Planning – 1808
Pay Range: $43.67 – $48.93 / hour
The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted.
Travel: No
Related Jobs
Search by License
Search Jobs by State
- Alabama
- Alaska
- Anywhere
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming