Acute Inpatient Psychiatric Nursing Specialist
3 days ago
The Utilization Review Nurse is a critical member of the Telecare Corp. 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 achieve optimal outcomes.
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
- Graduation from an accredited LVN program and two years of acute inpatient psychiatric nursing experience
- Current LVN State license and BLS certification
- Must be at least 18 years of age and CPR, Crisis Prevention Institute (CPI), and First Aid certified
- Ability to work independently and analyze treatment plans, which include the diagnosis of client behavioral and emotional problems
- Utilization Review Nurse experience
The Utilization Review Nurse will work in a fast-paced environment, requiring strong communication and problem-solving skills. The position requires manual dexterity, repetition, and the ability to work in a high-stress environment.
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