ChicoRecruiter Since 2001
the smart solution for Chico jobs

Utilization Review Nurse (RN)

Company: Enloe Medical Center
Location: Chico
Posted on: June 8, 2019

Job Description:

POSITION SUMMARY: The Utilization Review Nurse has responsibility for managing Utilization Review services for all payer types and all locations. Promotes and evaluates effective utilization of health care services with the use of clinical guidelines/standards. Communicates with payers, physicians, and the case management team regarding patient status, projected length of stay, expected outcomes, and discharge plan. Serves as a resource to Case Management staff and medical staff for facilitation of patients moving to appropriate level of care. Performs admission and ongoing utilization reviews to evaluate appropriateness of admission criteria and utilization of secondary review process. Supports organizational efforts to assure accurate capture of admission status and helps with priority focus targeted utilization reviews. Ability to conduct admission reviews on all payer types, knowledge of admission screening criteria and case management processes. Provide clinical data for commercial payers for continued stay as assigned. Provides clinical data to external agencies as required for admission certification and continued stay. Management of Utilization Review worklists and other duties as assigned. Must meet the productivity standards for completion of Utilization Reviews for the position. The Utilization Review Nurse contributes to the service excellence mission of Enloe Medical Center and the Case Management Department. EDUCATION / TRAINING / EXPERIENCE: Minimum: Two years recent experience in an acute care setting OR recent internship with Case Management / Utilization Review Desired: Bachelor's degree in nursing. One-year experience in discharge planning preferred. Working knowledge of managed care requirements and hospital information systems. ACM Certification preferred LICENSES / CERTIFICATIONS: Registered nurse licensed in the state of California Current CPR certification SKILLS / KNOWLEDGE / ABILITIES: Understanding of third party reimbursement and admission/continued stay criteria utilizing Interqual criteria. Ability to establish smooth working relationships with physicians, staff, and external review organizations. Maintains and regularly updates clinical nursing knowledge. Proficient in the use of multiple computer software programs: Meditech, Chartmax, Excel, MIDAS. Demonstrates excellent verbal and written communication skills. Demonstrates evidence of strong skills in confidentiality, integrity, creativity, and initiative. Demonstrates ability to interact with a wide variety of individuals, and handle confidential information.

Keywords: Enloe Medical Center, Chico , Utilization Review Nurse (RN), Healthcare , Chico, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Healthcare Jobs

Registered Nurse (RN) - 2 Central
Description: ALL Units Admitting Telemetry --PatientsDysrhythmia recognition course or demonstrated competency and ACLS required.Critical Care UnitsDysrhythmia recognition course or
Company: Rideout Health
Location: Marysville
Posted on: 06/26/2019

Labor & Delivery Surgical Technologist CST/ST Travel
Description: Travel Surgical Technician Numerous Nationwide Travel Assignments / JobsLabor Delivery experience CST / ST br Tired of completing an application just to get informationClick the View or Apply button (more...)
Company: HealthCare Traveler Jobs
Location: Fairfield
Posted on: 06/26/2019

Travel Nurse - ICU RN - Walnut Creek, CA
Description: Travel ICU Registered Nurse RN Start your next travel opportunity with this great Registered Nurse RN positon in Walnut Creek, CA.Job Details 2,500 - 2,400 weekly gross pay.12 hour
Company: General Healthcare Resources - Travel Nursing
Location: Sacramento
Posted on: 06/26/2019

Speech-Language Pathologist
Description: The Stepping Stones Group is currently interviewing Speech-Language Pathologists for the 19/20 SY in Fairfield, CA Job Requirements CA SLP License K-5 Caseload Background check and fingerprinting required (more...)
Company: The Stepping Stones Group
Location: Fairfield
Posted on: 06/26/2019

Orthopedic Surgical Technologist CST/ST Travel
Description: Travel Surgical Technician Numerous Nationwide Travel Assignments / JobsOrthopedic experience CST / STTired of completing an application just to get informationClick the View or Apply button for HCEN's (more...)
Company: HealthCare Traveler Jobs
Location: Fairfield
Posted on: 06/26/2019

Healthcare IT Research Programmner
Description: This position will also be responsible for and participate in the planning, developing and maintaining information systems which directly affect research and clinical lab equipment. Requirements Application (more...)
Company: HCTec Partners
Location: Sacramento
Posted on: 06/26/2019

Orthopedic Spine Surgeon Opportunity in Roseville, CA
Description: A well-established private practice group Sierra Spine Institute in Roseville, CAis seeking an Orthopedic Spine Surgeon. Candidates must be fellowship trained in Spine Surgery. The practice is conveniently (more...)
Company: Sutter Health Sacramento Sierra Region
Location: Roseville
Posted on: 06/26/2019

Physical Therapist - PT
Description: Physical Therapist - Home Health Position: Physical Therapist Specialty: Home Health 13 week Home Health Physical Therapist travel assignment Hospital in Sacramento, CA is looking for a Home Health Physical (more...)
Company: Fusion Medical Staffing
Location: Sacramento
Posted on: 06/26/2019

Registered Dental Assistant
Description: Patient-Centric Registered Dental AssistantOur growing dental practice needs a Registered Dental Assistant to join our close-knit team. We serve all demographics of the population, from preschoolers to (more...)
Company: Marconi Dental Group
Location: Carmichael
Posted on: 06/26/2019

Colorectal Surgery NP
Description: Job Description br br The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment (more...)
Company: University of California - Davis Medical Centers
Location: Davis
Posted on: 06/26/2019

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Chico RSS job feeds