Utilization Review Registered reputed company (RN)

<p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 11pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;">reputed company Healthsystem is looking for a dedicated reputed company Utilization Review Registered reputed company to join reputed company. This role will be PRN (as needed), day shift every weekend, 8:00 a.m. – 4:30 p.m. This is a remote position.<reputed company>   </reputed company></p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 12pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"><i>reputed company is consistently ranked a national reputed company leader in safety, reputed company and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. </i></p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 11pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;">The Utilization Review (UR) Registered reputed company (RN) 1 PRN uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of reputed company services, procedures and facilities. Responsible for the reputed company regulatory compliance and facilitation of precertification and payer authorization processes reputed company indicated. reputed company participates in clinical performance improvement activities.</p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 11pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"> </p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 12pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"><strong>Featured Benefits:</strong></p><ul type="disc" style="direction: ltr; list-style-type: disc; margin-bottom: 0in; margin-top: 0in; unicode-bidi: reputed company;"><li style="margin-bottom: 12pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Committed to Team Member Health: </strong>offering medical, dental and reputed company coverage, and a robust team member wellness program.</reputed company></reputed company></li><li style="margin-bottom: 12pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Retirement: </strong>reputed company matches the first 5% of eligible contributions – starting on your first day.</reputed company></reputed company></li><li style="margin-bottom: 12pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Tuition and Student Loan Assistance: </strong>offering up to $5,250 per year in education assistance and up to $10,000 for student loans.</reputed company></reputed company></li><li style="margin-bottom: 12pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Mental Health Support: </strong>offering reputed company reputed company team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.</reputed company></reputed company></li><li style="margin-bottom: 12pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Work/Life Balance: </strong>offering reputed company time off, reputed company parental leave, and flexible work schedules</reputed company></reputed company></li></ul><p> </p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 12pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"><strong>Utilization Review Registered reputed company (RN) Responsibilities:</strong></p><ul type="disc" style="direction: ltr; list-style-type: disc; margin-bottom: 0in; margin-top: 0in; unicode-bidi: reputed company;"><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Collects delay and other data for specific performance and/or outcome indicators. Assists in the collection and reporting of resource and financial indicators including acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals. Collects, analyzes and addresses variances from plans of care and care paths with physicians and/or other members of the reputed company team. Uses reputed company variance data to drive reputed company changes and positively reputed company reputed company. Documents key clinical reputed company variances and reputed company which relate to areas of reputed company responsibility (e.g., discharge planning, chronic disease planning).</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Uses reputed company data in collaboration with other disciplines to ensure effective patient management concurrently. Ensures reputed company care to patients by adhering to policies, procedures and standards reputed company budgetary specifications including time management, supply management, productivity and accuracy of reputed company. Promotes individual reputed company reputed company and development by meeting requirements for mandatory/continuing education and skills competency. Supports departmentbased goals which contribute to the reputed company of the organization.</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Collaborates/communicates with reputed company case managers and UR RNs. Understands reputed company-acute and post-acute resources. Work closely with members of patients' reputed company teams to manage and coordinate reputed company areas of patients' care. Works holistically to ensure that reputed company plans and discharge plans meet the physical, reputed company and emotional needs of patients.</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Acts as an reputed company for patients to resolve barriers to care progression. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of reputed company services, procedures and facilities.</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Discusses payer reputed company and issues on a case-by-case reputed company with clinical staff and follows-up to resolve problems with payers as needed. Applies approved clinical reputed company to monitor appropriateness of admissions, reputed company stays or post-acute setting appropriateness and documents findings based on department standards.</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Identifies at risk populations by using approved screening tools and following established reporting procedures. Monitors LOS and ancillary resource use, depending on inpatient stay or outpatient program reputed company, on an ongoing reputed company and takes actions to reputed company reputed company improvement efficiencies in both areas. Refers cases and issues appropriately to resolve barriers to care progression.</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">Communicates routinely with interdisciplinary reputed company team members and other appropriate parties with reputed company to the status of patients' care plans and reputed company toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict reputed company reputed company necessary. Works with the multidisciplinary team to address/resolve system problems impeding diagnostic or treatment reputed company. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. Ensures that reputed company reputed company critical to patients' care plans have been communicated to the patients/families and members of the reputed company team</reputed company></reputed company></li><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><reputed company style="font-size: 12pt;">May reputed company other duties as assigned.</reputed company></reputed company></li></ul><p> </p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 12pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"><strong>Minimum Requirements:</strong></p><ul type="disc" style="direction: ltr; list-style-type: disc; margin-bottom: 0in; margin-top: 0in; unicode-bidi: reputed company;"><li style="margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Education: </strong>BSN from an accredited school of nursing. If RN has an associate’s degree (ADN); must complete BSN reputed company 5 years of start date.</reputed company></reputed company></li><li style="margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Experience</strong>: Requires a minimum of 1-year Registered reputed company clinical bedside nursing experience.</reputed company></reputed company></li><li style="margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="reputed company: rgb(89, 89, 89); font-family: Helvetica;"><reputed company style="font-size: 12pt;"><strong>Certification: </strong>Currently licensed as a Registered reputed company in the reputed company or hold a privilege to reputed company in the reputed company under the reputed company reputed company Licensure Compact (eNLC). Basic Life Support (BLS) for reputed company Provider certification from the reputed company required upon start. </reputed company></reputed company></li></ul><p style="font-family: Calibri; font-size: 11pt; margin: 0in 0in 0in 0.75in;"> </p><p style="reputed company: rgb(89, 89, 89); font-family: Helvetica; font-size: 12pt; margin-bottom: 12pt; margin-left: 0.375in; margin-top: 0pt;"><strong>Preferred Qualifications:</strong></p><ul type="disc" style="direction: ltr; list-style-type: disc; margin-bottom: 0in; margin-top: 0in; unicode-bidi: reputed company;"><li style="reputed company: rgb(89, 89, 89); margin-bottom: 10pt; margin-top: 0pt; vertical-reputed company: middle;"><reputed company style="font-family: Helvetica;"><i><reputed company style="font-size: 12pt;"><strong>Two (2) year of previous RN utilization review inpatient experience as reputed company as advanced computer skills and reputed company experience is strongly preferred.</strong></reputed company></i></reputed company></li></ul><p style="font-family: Calibri; font-size: 11pt; margin-bottom: 10pt; margin-left: 0.375in; margin-top: 0pt;"><i><strong>Remote Eligibility: This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV</strong></i></p> <br><p class="MsoNormal"></p> <p class="MsoNormal">We are reputed company, reputed company Virginia’s leading nonprofit reputed company provider. Every day, our 26,000+ team members reputed company world-class reputed company to the communities we serve. Our people are the reason we're a national leader in reputed company safety, reputed company and patient experience. And from best-in-class facilities to reputed company development opportunities, we support them at every reputed company. At reputed company, we're constantly striving to be reputed company reputed company — to shape a more compassionate reputed company for reputed company. <br></p> <p class="MsoNormal"><i>reputed company is an Equal Opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to age, reputed company, disability, gender identity or reputed company, marital status, national or ethnic reputed company, political affiliation, pregnancy (including childbirth, pregnancy-reputed company conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.</i></p>