Acute Psychiatric Nurse Practitioner

3 weeks ago


Santa Cruz, California, United States Telecare Corporation Full time
Job Summary

The Utilization Review Nurse is a vital member of the Telecare team, responsible for ensuring that the care provided to our members is appropriate and medically necessary. This role requires a strong understanding of psychiatric nursing principles and the ability to work collaboratively with the treatment team to ensure high-quality care.

Key Responsibilities
  • Review members' admission data and clinical documentation to ensure compliance with county and state regulations
  • Interview members' significant others and consult with existing outpatient teams as needed
  • Consult with psychiatrists and medical staff regarding members' diagnoses, medical justification, length of treatment, and case documentation
  • Assess records for appropriate level of care and treatment, aftercare, and discharge planning for members
  • Present treatment plan disagreements to the treatment team and advocate for required members' treatment with medical providers
  • Provide training and information about utilization requirements to clinical, supervisory, and management staff
  • Participate in Quality Assurance (QA) survey audits of the program to ensure agency compliance on utilization review regulations
Requirements
  • Graduation from an accredited LVN program
  • Two years of acute inpatient psychiatric nursing experience
  • Current LVN State license
  • Current BLS certification
Preferred Qualifications
  • Utilization Review Nurse experience
Working Conditions

The Utilization Review Nurse will work in a fast-paced, dynamic environment, requiring strong communication and interpersonal skills. The ability to work independently and make critical decisions about medical necessity is essential.



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