RN Utilization Management

2 months ago


La Crosse, United States GUNDERSEN LUTHERAN ADMINISTRATIVE Full time

JOB REQUIREMENTS: Love + medicine is who we are, it\'s what we do, it\'s why people want to work here. If you\'re looking for a job to love, apply today. Schedule Weekly Hours:36 Gundersen Health System is seeking a full-time Registered Nurse for our Utilization Management department. This is your opportunity to work the day shift while doing what you love in the beautiful coulee region. What you will do: Fulfill 72 hours per two weeks = 0.9 FTE Work Monday through Friday, 8-hour day shifts with one day off per two-week pay period; one Saturday approximately every other month The Utilization Management Specialist has the important task of evaluating whether the medical record matches the clinical picture for revenue integrity, to ensure that the patient\'s hospitalization and services are reasonable and necessary. Work with an interdisciplinary team consisting of attending teams, admissions, social services, and revenue cycle This work is mostly spent \"behind the scenes\" with occasional patient contact What you will get: Starting pay of \$32.20/hour + more for experience While this position is on-site, there may be an opportunity for hybrid work following one year of successful full-time work This position allows for flexible start/end times between the hours of 0730-1700. Hours during orientation will be 0800 - 1630. Support to grow in your career with access to our Career Development Center and Tuition Investment Program Top-rated retirement plan and healthcare benefits What you need: Minimum of Associate Degree in Nursing Minimum of 2 years RN experience RN licensure to practice in the state of Wisconsin upon hire Gundersen Health System is healthcare for neighbors, by neighbors. While we call La Crosse home, our system has 7 hospitals and 65 clinics in neighboring communities. Inside our walls and our neighborhoods, we deliver world-class medical care combined with the right amount of love. We call it Love + Medicine and it\'s who we are. Explore why La Crosse is a great place to live and workJob Description: The Utilization Management Specialist performs medical necessity review of initial patient placement and continued stay review for hospitalizations. Applies nationally recognized criteria during review of patients\' medical records. Provides communication on review determinations to the attending physician and external review organizations as required by the patients insurance coverage or by Gundersen Health Systems contract. Collaborates with the health care team to assure that patient needs and discharge plans are documented and certified as medically necessary. Monitors patient progress and outcomes towards goals. Assists with management of health care benefits and assists the patient/healthcare team in obtaining necessary services. Participates in performance improvement activities to achieve safe quality patient care and assure compliance with... For full info follow application link. EEO/AA/Veterans/Disabilities ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/A577E54D5BB643B3



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