Utilization Review RN

3 months ago

Everett, United States Providence St. Joseph Health Full time

Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Medical Center Everett received the HealthGrades Distinguished Hospital Award for Clinical Excellence four years in a row. Required Qualifications: Bachelor's Degree in Nursing (BSN). Must obtain a Bachelor's degree in Nursing or higher within (5) years of hire. Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individual and facility will remain in effect. Any collective bargaining contract with specific time frames for obtaining a Bachelor's degree in nursing will supersede the above point and will remain in effect. Exceptions will be considered on a case-by-case basis at each facility by the most senior administrative nursing leader in consultation with the Human Resources leader. Upon hire: Washington Registered Nurse License Experience as an RN in an acute care setting within the last 5 years, OR recent Utilization Management experience. Preferred Qualifications: Utilization review or case management experience. Experience with Interqual or Milliman Criteria. Care Management, medical insurance or discharge planning experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards. About the Team Providence has been serving the Pacific Northwest since 1856 when Mother Joseph and four other Sisters of Providence arrived in Vancouver, Washington Territory. Today, Providence is the largest health care provider in Washington located in communities large and small across the state. In western Washington, Providence provides care throughout the greater Puget Sound from Snohomish County to Lewis County. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient heal

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