staff - Registered Nurse (RN) - Manager - $33+ per hour
2 weeks ago
Saint Francis Health System is seeking a Registered Nurse (RN) Manager for a nursing job in Tulsa, Oklahoma.
Start Date: ASAP
Employment Type: Staff
Full Time
Hours: Monday - Friday | 11:00pm - 7:00a
Provides administrative and clinical support to the hospital and treatment teams throughout the review of patients including, but not limited to their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details of reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to the improvement of internal processes.
Minimum Education: Has completed the basic professional curricula of a school of nursing as approved and verified by a state board of nursing, and holds or is entitled to hold a diploma or degree therefrom or Master's degree in Nursing.
Licensure, Registration and/or Certification: Work Experience: Minimum 3 years of related experience in an acute care setting.
Demonstrated ability to integrate the analysis of data to discover facts or develop knowledge, concepts, or interpretations. Ability to be detail oriented as required in the examination of numerical data. Ability to synthesize clinical case data into concise summaries. Working knowledge of Microsoft Word, Excel and Access in the preparation of correspondence and reports.
Participates in treatment team and/or Patient Care Committee by providing information about eligibility, benefits, and criteria for the selected level of care. Identifies QI Triggers for individual patient situations, reporting them promptly to the UM Manager, appropriate clinicians and Process Improvement/Quality Director. Reviews eligibility and benefits of patients to validate accurate level of care utilization. Investigates and prepares appeals for insurance companies when denial of reimbursement is related to medical necessity or to other treatment issues. Participates in quality-of-care and UM process improvement on an ongoing basis and assists with development of the UR Staff Committee's process improvement goals. Provides staff education to further the goals of UR.
Works with internal customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. Utilization Review Management - Yale Campus
EOE Protected Veterans/Disability
Saint Francis Healthcare System Tulsa Job ID #JR14041. Utilization Management Nurse (Rn) | M - F | 11P - 7A
About Saint Francis Health System
Saint Francis Health System is a Catholic, not-for-profit health system wholly owned and operated in Tulsa, Oklahoma whose mission is to extend the presence and healing ministry of Christ to all who seek its services. The health system is anchored by Saint Francis Hospital, a 1,112-bed tertiary center, which includes the region's only children's hospital and level IV neonatal intensive care unit, a 168-bed heart hospital and Tulsa's leading trauma and emergency center. Additionally, Saint Francis employs more than 450 providers through Warren Clinic, which serves the region with more than 95 locations throughout eastern Oklahoma. In total, the organization has more than 11,500 employees, 1,000 physicians and 700 volunteers, making it the largest private employer in Tulsa County.
Holiday Pay
~ 401k retirement plan
~ Employee assistance programs
~ Medical benefits
~ Dental benefits
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