What are the responsibilities and job description for the Utilization Review RN ARRMC (Case Management) position at Asante Health System?
Utilization Review RN ARRMC (Case Management)
Additional Position Details: FTE: 0.900000 | Full Time | Variable Hours/Variable Days
Salary: Starting at $45.26 an hour and increases are based on qualifications and years of experience in the field. Plus, you will earn extra shift differentials for weekend hours:
- $2.20 extra for working weekends
Position Summary
The Utilization Review Nurse monitors utilization practices from preadmission to discharge to assure cost-effective, quality patient care and to ensure that patient, physician, and hospital/system receive maximum benefits from the health plan. Also ensures compliance with all regulatory requirements involved in the continuum of care. In this role, general responsibilities include:
- Receiving and disseminating information related to system, departmental, and patient processes
- Participating in data collection activities to support departmental programs and services
- Monitoring and reporting on patient outcomes and actively working with other members of the interdisciplinary team to facilitate improved delivery of cost-effective services
- Conducting utilization review, evaluating clinical information, and communicating findings to payors within the framework of contractual and government regulations
- Reviewing all admissions for appropriate inpatient vs. outpatient / observation status
Qualifications
- 2 recent years of progressive nursing experience in an acute care setting preferably within discharge, utilization and/or case management or equivalent combination of education and/or experience
- RN: Registered Nurse licensed by Oregon State Board of Nursing is required upon start
Preferred Qualifications
- Bachelor's degree in nursing
- CCM: Certified Case Manager
- ACM: Accredited Case Manager
Total Rewards Package
- Earn a competitive and progressive salary
- Benefit from health plans that are focused on health and wellness including medical, dental, vision and wellness beginning within 30 days of hire
- On-call employees may receive an additional 15% for flexibility
- Plan for your future with a retirement package that includes up to 6% employer contribution
- Experience a healthy work-life balance with our generous earned time off (ETO)
- Continue to enhance your education through our tuition reimbursement and tuition repayment plans
At Asante, we are guided by our values below. Explore Asante more by visiting www.asante.org/careers
Excellence - Respect - Honesty - Service - Teamwork
Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.
Salary : $45
