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RN Utilization Review Coordinator- Lavonia, GA

2 months ago


Athens, United States St. Mary's Health Care System Full time
Employment Type

Full time

Shift

Day Shift

Description

THIS POSITIONS IS LOCATED IN LAVONIA, GEORGIA

Position Summary: The Care Coordinator/UR, in collaboration with other healthcare professionals, is responsible for implementing an interdisciplinary process for evaluating the options and services required to meet an individual’s health care needs from admission to the acute care setting through return to the community for a specific caseload of patients. The care coordinator is also responsible for conducting initial and concurrent chart reviews on Federal and self-payers for the purpose of utilization review as well as identifying patients requiring case management follow-up. This includes a biopsychosocial assessment of the patients, their response to treatment, identifying and alerting the physicians of possible actions to reduce delays associated with extended stays. The care coordinator enhances cost-effective use of resources by identifying and initiating discharge planning to accomplish the timely transition of patients to a post-hospital setting. The care coordinator must have in-depth knowledge of system and community resources and referral agencies. The care coordinator is responsible for communicating with external agencies to provide referral information for a smooth transition from hospital to the post-hospital setting. This includes communication with other healthcare agencies and payer sources. This position will also assure proper identification of principal and secondary diagnosis in collaboration with the treating physician.

Position Requirements

Licensure/Certification/Registration: Current GA RN license. BLS required – must be obtained within initial 90-days of employment.

Education: Must be a graduate of an accredited school of nursing

Experience: Must have a minimum of 2 years’ experience in nursing, preferably in a hospital setting and a minimum of 1 year in case management, utilization management, or discharge planning preferred.

Special Qualifications: Excellent communication, interpersonal, and critical thinking skills.

Degree of Supervision Required: Indirect and periodic supervision. Must be capable of working independently.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.