Care Management Coordinator
3 weeks ago
Overview
At CHI St. Vincent Little Rock, we are seeking a highly skilled Utilization Review Nurse to join our team.
We offer an estimated salary of $83,000 - $118,000 per year, depending on experience and qualifications.
The successful candidate will work closely with physicians, other registered nurses, specialized departments, and community resources to provide patients with the education and resources needed to build a care plan at discharge.
The Utilization Review Nurse will analyze insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients.
Key Responsibilities:
- Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients.
- Reviews medical records for appropriate level of care.
- Compares inpatient medical records to established criteria and confers with medical and nursing personnel and other professional staff to determine appropriateness of treatment and length of stay.
- Abstracts data from records and maintains statistics.
- Monitors and tracks Medicare denials, works with medical records to review third-party payor denials.
- Works with other disciplines to develop a discharge plan appropriate for patients' identified needs.
- Works closely with providers regarding patient status and appropriate level of care.
- Rounds on patients, available to answer questions and help with discharge planning needs of patients.
- Records all care information concisely, accurately, and completely, in a timely manner, in the appropriate format, and on the appropriate forms.
Qualifications:
- Unencumbered license to practice in the State of Arkansas.
- 4 years of acute care nursing experience required.
- BSN Required.
- Previous case management, utilization management, or discharge planning experience strongly preferred.
Join us at CHI St. Vincent Little Rock and be part of a dynamic team that is dedicated to providing high-quality patient care.
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