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Time Type:

Part time

Hours per Pay Period:

40

Shift:

As Assigned

Minimum:

$47.82 USD

Maximum:

$71.26 USD(This represents the rate for an individual with significant experience in this job)

Department:

Acute Psychiatric Unit

Current Bay Area Hospital Employee: If you are a current Bay Area Hospital employee, please apply through the Workday internal career site.

The future looks bright at Bay Area Hospital, and we are always searching for quality people to join our team. We offer a great atmosphere, competitive pay, a wide array of benefits, and many growth opportunities for our employees.

Job Description:

Utilization Review RN

Applies clinical expertise and medical appropriateness criteria to resource utilization and coordinator of the transitional planning process. Implementing effective and efficient Utilization Review (UR) processes in the acute healthcare setting. Conducts medical certification reviews for medical necessity using nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician. Serves as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations, and documentation improvement opportunities. Performs utilization review training and mentorship to assigned staff.

SKILLS AND ABILITIES

• Current knowledge/application of Interqual criteria
• Knowledge of Medicare regulations pertaining to utilization management
• Working knowledge of CMS Condition Code 44 guidelines
• Excellent critical thinking and communication skills
• Ability to read, write legibly, and converse effectively in the English language
• Maintains regular, consistent and punctual attendance at the assigned job location
• Exercises good judgment, demonstrates effective critical thinking skills
• Flexible, able to prioritize and address multiple responsibilities concurrently
• Works effectively under stress and frequently changing job requirements/situations
• Ability to plan, organize and prioritize work, coordinate activities and projects, follow up on work assignments, and adhere to timelines
• Ability to train and mentor staff while promoting an atmosphere of teamwork and cooperation
• Strong computer skills needed

EDUCATION/CERTIFICATIONS/LICENSES/DEGREES

• Licensed to practice as a Registered Nurse in the state of Oregon
• Graduation from an accredited school of nursing
• Bachelor’s preferred
• Obtain UR and/or Case Management Certification within 2 years 
• American Heart Association Healthcare Provider Basic Life Support (BLS)

EXPERIENCE

• Minimum of two (2) years of recent experience in Utilization Review and Case Management/Care Coordination in a hospital setting
• Prior supervisory/leadership experience preferred

GENERAL INFORMATION

Union Affiliation:  None

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position.  They are not intended to be an exhaustive list of all duties, responsibilities and job skills required. 

Physical/Mental/Environmental Requirements

• Able to stand, walk, bend, squat, reach, and stretch frequently
• Possess physical agility and adequate reaction time to respond quickly and appropriately to unexpected patient care needs
• Have adequate hearing and visual acuity, including adequate color vision
• Must use standard precautions due to threat of exposure to blood and bodily fluids
• Ability to communicate effectively through reading, writing, and speaking in person or on telephone
• Able to use a computer

Compensation Grade:

ONA

Compensation Grade Profile:

Bay Area Hospital is an Equal Opportunity Employer.

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