What are the responsibilities and job description for the Utilization Review RN position at Yavapai Regional Medical Center?
Overview
At Dignity Health living our values means bringing passion into action every day. Dignity Health-Yavapai Regional Medical Center (DH-YRMC) now part of CommonSpirit Health is a not-for-profit integrated healthcare provider that offers a broad range of inpatient and outpatient services including network-wide opportunities to advance your career.
What started as a simple community hospital is today a state-of-the-art healthcare system with two acute care hospitals a network of primary and specialty care clinics outpatient health and wellness centers cardiac diagnostic centers and outpatient medical imaging centers.
As you build your career at DH-YRMC you’ll find Prescott is an inspiring place to live work and to enjoy the outdoors.
Responsibilities
Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical thinking. Collaborates with the Concurrent Denial RNs to determine the root cause of denials and implement denial prevention strategies. Collaborates with Patient Access to establish and verify the correct payer source for patient stays and documents the interactions. Obtains inpatient authorization or provides clinical guidance to Payer Communications staff to support communication with the insurance providers to obtain admission and continued stay authorizations as required within the market.
Qualifications
Required
Preferred
Pay Range
$36.96 - $53.60 /hour
At Dignity Health living our values means bringing passion into action every day. Dignity Health-Yavapai Regional Medical Center (DH-YRMC) now part of CommonSpirit Health is a not-for-profit integrated healthcare provider that offers a broad range of inpatient and outpatient services including network-wide opportunities to advance your career.
- Our exceptional benefits package includes:
- Competitive compensation
- Flexible scheduling
- Career growth opportunities
- Tuition reimbursement
- Relocation assistance for eligible position
What started as a simple community hospital is today a state-of-the-art healthcare system with two acute care hospitals a network of primary and specialty care clinics outpatient health and wellness centers cardiac diagnostic centers and outpatient medical imaging centers.
As you build your career at DH-YRMC you’ll find Prescott is an inspiring place to live work and to enjoy the outdoors.
- It is an inviting community with bygone charm and modern amenities.
- Local residents enjoy four spectacular seasons while the area offers nearly year-round sunshine for any outdoor adventures.
- The carefree relaxed lifestyle offers short commute opportunities so you can focus on your career and your family.
Dignity Health-Yavapai Regional Medical Center extends this feeling with a strong sense of family security and belonging. Our compassion and commitment to quality care has earned awards such as the Stroke Care Excellence Award (2022) Neuroscience Excellence Award (2021 2020) and America’s 100 Best Hospitals for Stroke Care Awards (2020 2021) and has placed us at the top of the charts in community and nationwide in healthcare. Come experience the incredible quality-of-life that Dignity Health-YRMC and Prescott has to offer! #hellohumankindness
Responsibilities
Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical thinking. Collaborates with the Concurrent Denial RNs to determine the root cause of denials and implement denial prevention strategies. Collaborates with Patient Access to establish and verify the correct payer source for patient stays and documents the interactions. Obtains inpatient authorization or provides clinical guidance to Payer Communications staff to support communication with the insurance providers to obtain admission and continued stay authorizations as required within the market.
Qualifications
Required
- Graduate of an accredited school of nursing
- Minimum two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience.
- RN:AZ or Compact License
- Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used.
Preferred
- Bachelor's Degree in Nursing (BSN) or related healthcare field.
- At least five (5) years of nursing experience.
- Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred
Pay Range
$36.96 - $53.60 /hour
Salary : $37 - $54
