What are the responsibilities and job description for the Utilization Review Registered Nurse - Hybrid position at Sentara?
Sentara Health is hiring a Full-Time Day shift
Utilization Review RN Case Management
for the Revenue Cycle Center in Norfolk, VA.
The position is located in Norfolk, VA and currently offering a hybrid opportunity.
As a Utilization Review Nurse/Integrated Care Manager RN with Sentara, you work together intensely with the patients, families, and members of the medical team to provide patients with the resources they need and help prevent them from being readmitted to the hospital. This position's primary duty is customizing what is best for the patients. That would include helping with things like home health, long-term care placement, home medical equipment, and homeless and community resources. You will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients.
Click https://youtu.be/3BE5pC5IfYo to hear Meredith tell us about a day in the life of a Utilization Review RN/Integrated Care Manager with Sentara Health.
- As a Utilization Review Nurse specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure.
- Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review.
- Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements.
- Responsible for written and /or verbal communication of pertinent clinical information.
Education
- Registered Nurse Diploma
- Educational coursework in anatomy, physiology, and current coding practices required.
Certification/Licensure
- Valid RN license
- For Integrated Care Management departments, specialty certification is required within one year of eligibility (ACM, CCM, CCCTM, CMAC, or CGMT-BC). For other service lines, certification based on specialty area is required within one year of eligibility.
Experience
- 3 years of acute care RN experience.
- Care Management Experience preferred.
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Salary : $1,000 - $1,000,000
