Registered Nurse - Utilization Review Case Manager

Missoula, MT 59801

Posted: 10/20/2020 Industry: Healthcare Job Number: 18828

Job Description

Utilization Review Case Manager Nurse

Full Time

***$10K SIGN ON BONUS***

McCall and Lee has been brought on to find a Registered Nurse of Utilization Review Case Management. If you are a individual that is looking to escape the hustle and bustle of the big city, for a scenic location surrounded by beautiful lakes, mountains, and amazing outdoor activity, this opportunity could be for you.


POSITION OVERVIEW:

The Case Manager Utilization Review Nurse promotes cost effective allocation of the resources while maintaining the highest quality of care. The UR/Case Manager is responsible for overseeing utilization of services, reviewing medical necessity of admission, appropriateness of setting, extended stays and professional services. Addresses medical necessity denials with attending physician and UR committee. The UR/Case Manager reports statistical information including but not limited to the number of admissions, payor source, length of stay, condition 44s, condition code W2 and number of readmissions. The UR/Case Manager is responsible for the completion and documentation of the discharge plan evaluation and the coordination and documentation of the discharge plan. The UR/Case Manager RN works with the multidisciplinary team to ensure that all patients are safely transitioned to the most appropriate level of care once the physician has determined acute care is not longer necessary. In collaboration with the patient’s primary nurse, the UR/Case Manager RN will assist in providing thorough patient education, and discharge instructions as appropriate. With the support of Administration and Clinical Leadership, the UR/Case Manager RN will comply with Joint Commission standards for Case Management/Discharge planning and Utilization Review.


SHIFT:
Monday - Friday 8:00AM - 5:00PM


MINIMUM QUALIFICATIONS:

Must be a registered nurse and have minimally 3 years experience in nursing. Requires experience in chart review.


LICENSE/CERTIFICATION

Graduate from accredited Nursing Program; Bachelor’s Degree preferred


KNOWLEDGE/SKILLS/ABILITIES

Utilization Review, Case Management, and Quality Review and Management experience preferred. Needs to be highly skilled interacting with people at all levels of the organization. Must possess exceptional leadership and interpersonal skills, be customer service oriented, and work as an integral part of the team. Requires flexibility, independent thinking, and problem solving skills. Must be able to demonstrate ability to initiate and develop special projects. Must be able to handle a busy work load.


If you are interested in applying for this position please reach out to the recruiter listed below:

Matt Morgan | Recruiter
mattm@mleehealthcare.com

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