ED Utilization Management Nurse

Found in: Lensa US P 2 C2 - 2 weeks ago

Chardon, United States University Hospitals Full time
This role is for two (2) 12hours per week and this is a night position 10P-10A requiring every 3 rd weekend and Friday rotation.

Essential Functions
  • Collaborates and coordinates with all members of the health care team, patient and family (or significant others) to coordinate and ensure timely and efficient delivery of required workflow, services and tasks to result in:

    • Support of positive patient health care outcomes

    • Increased patient/health care team outcomes and satisfaction

    • Improved inpatient throughput and appropriate length of stay

    • Improved communication, awareness and adherence to regulatory requirements associated with utilization

    • Support for inappropriate level of care and decreased inpatient bed day denials

    • Continuity and coordination of care

    • Appropriate and timely authorization for level of care

    • Decreased denials

    • Appropriate reimbursement

  • Performs and documents timely and accurate concurrent review of records and discusses plan of care with ED physicians to support the decision making process with regard to LOC decisions inpatient admission or outpatient observation services. (60%)

    • Supports effective and timely communication of the physician decision regarding inpatient admission or outpatient observation services for accurate registration status, and delivery of appropriate notices to patient when required (ie IMM delivered by registration staff).

  • Conducts all CM activities with a focus on continuous quality improvement in a manner that is supportive of UHC quality initiatives and in compliance with applicable regulatory requirements.
Required For All Jobs
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • For specific duties and responsibilities, refer to documentation provided by the department during orientation.
  • Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Qualifications:
Education
  • Graduate of an accredited school of Nursing Required
  • Bachelor's Degree Preferred
Work Experience
  • 3+ years Of clinical experience (acute care) Required
  • 1+ years Of experience in utilization management/case management in an acute care setting Required
  • Experience as an ED nurse Preferred
  • Experience in ED utilization management/case management Preferred
  • Experience with Interqual or Milliman criteria Preferred
Knowledge, Skills, & Abilities
  • Must have sound clinical knowledge base of the population to be served required
  • Knowledge of Medicare, Medicaid and commercial payer regulations preferred
  • Detail-oriented and organized, with good analytical and problem solving ability required
  • Notable client service, communication, presentation and relationship building skills required
  • Ability to function independently and as a team player in a fast-paced environment required
  • Must have strong written and verbal communication skills required
  • Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.) required
  • Demonstrated ability to apply concepts, utilize sound judgment and work independently within a framework of guidelines required
  • CM software proficient preferred
Licenses and Certifications
  • Registered Nurse (RN) in the State of Ohio Required
Additional Licenses and Certifications
  • CM certificate Preferred

recblid ib8mb8ka98hjvzwsigruriyp639qf3

  • Nursing Supervisor

    1 week ago

    Chardon, United States University Hospitals Full time

    Facilitates movement of patients to appropriate and alternate levels of care as needed and has the authority to facilitate the opening of transitional beds/unit in order to maximize patient throughput and ease excess capacity. This also includes patient access, transfer center and system wide coordination. Takes physician orders and completes admission...

  • Nursing Supervisor- Seidman Inpatient area

    3 days ago

    Chardon, United States University Hospitals Full time

    Facilitates movement of patients to appropriate and alternate levels of care as needed and has the authority to facilitate the opening of transitional beds/unit in order to maximize patient throughput and ease excess capacity. This also includes patient access, transfer center and system wide coordination. Takes physician orders and completes admission...

  • Sepsis Coordinator

    1 week ago

    Chardon, United States University Hospitals Full time

    DescriptionResponsible for the organization of patient care for patient with suspected sepsis or confirmed sepsis. Coordinates patient care services with an emphasis on clinical guidelines and outcomes management. Sepsis coordinator leads, directs and negotiates through collaboration with physicians and staff to promote care delivery that assures efficiency,...

  • Registered Nurse Cardiac Cath Lab

    Found in: beBee S US - 2 weeks ago

    Chardon, United States University Hospitals Full time

    DescriptionProvides safe efficient age specific nursing care to patients and families using the nursing process in order to assist them to attain, maintain, regain, and sustain optimal health status. Implements the nursing process by delivering effective relationship based nursing care. Demonstrates technical skills in care delivery that result in safe...

  • Registered Nurse

    Found in: Lensa US P 2 C2 - 2 weeks ago

    Chardon, United States University Hospitals Full time

    Registered Nurse Level 1 BSN To Heal. To Teach. To Discover. At University Hospitals, this is more than just our mission. These words embody the opportunities available to the many world-class doctors, nurses, health care professionals, and support staff that choose to join UH and Be the Difference. A Brief Overview Provides safe efficient age specific...

  • Paramedic - ED - PRN

    Found in: Lensa US P 2 C2 - 2 weeks ago

    Chardon, United States University Hospitals Full time

    Position SummaryAssist patients and health care needs as directed by clinician during Emergency Department visit including performing 12 lead EKGs, blood draws, initiate Hep-locks, bedside point of care testing, aerosol treatments. Ensures the daily completion of point of care testing quality controls, defibrillator checks, refrigerator checks, transports....

  • Assistant Nurse Manager

    20 hours ago

    Chardon, United States University Hospitals Full time

    Job DescriptionDescriptionPosition SummaryTo maintain the nursing staff in all areas as well as to deliver safe efficient age specific nursing care to patient/families. Essential FunctionsRoutinely provide patient care.Collaborate with the interdisciplinary team.Maintains employee records.Identifies needs for and provides Staff education/staff...

  • Sepsis Coordinator

    Found in: Careerbuilder One Red US C2 - 3 weeks ago

    Chardon, OH, US University Hospitals Full time

    DescriptionResponsible for the organization of patient care for patient with suspected sepsis or confirmed sepsis. Coordinates patient care services with an emphasis on clinical guidelines and outcomes management. Sepsis coordinator leads, directs and negotiates through collaboration with physicians and staff to promote care delivery that assures efficiency,...

  • Assistant Nurse Manager

    1 week ago

    Chardon, United States University Hospitals Full time

    DescriptionPosition SummaryTo maintain the nursing staff in all areas as well as to deliver safe efficient age specific nursing care to patient/families. Essential FunctionsRoutinely provide patient care.Collaborate with the interdisciplinary team.Maintains employee records.Identifies needs for and provides Staff education/staff development.Participates in...

  • Registered Nurse Cardiac Cath Lab

    Found in: Careerbuilder One Red US C2 - 3 weeks ago

    Chardon, OH, US University Hospitals Full time

    DescriptionProvides safe efficient age specific nursing care to patients and families using the nursing process in order to assist them to attain, maintain, regain, and sustain optimal health status. Implements the nursing process by delivering effective relationship based nursing care. Demonstrates technical skills in care delivery that result in safe...

  • Surgical Technologist- Geauga OR

    Found in: Lensa US P 2 C2 - 2 weeks ago

    Chardon, United States University Hospitals Pain Management Full time

    Description $3000 sign-on bonus after 90 days of employment for 1+ years external Surg Tech experience Essential Functions Provide safe efficient age specific nursing care to patients/families using nursing interventions in order to assist them to attain, maintain, regain, and sustain optimal health status. Provide patient care/function in a primary scrub...

  • Travel Nurse

    Found in: Talent US A C2 - 2 days ago

    Chardon, United States MedUS Healthcare Full time

    MedUS Healthcare is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in Chardon, OH. Shift: 4x10 hr days Start Date: 05/26/2024 Duration: 13 weeks Pay: $1885 / Week About MedUS Healthcare:MedUS Healthcare, formerly Axis Providers, is a Joint Commission certified staffing company that specializes in the recruitment,...

  • Travel Nurse

    Found in: Talent US A C2 - 2 weeks ago

    Chardon, United States MedUS Healthcare Full time

    MedUS Healthcare is seeking an experienced Cath Lab Registered Nurse for an exciting Travel Nursing job in Chardon, OH. Shift: 4x10 hr days Start Date: 05/20/2024 Duration: 13 weeks Pay: $2003 / Week About MedUS Healthcare:MedUS Healthcare, formerly Axis Providers, is a Joint Commission certified staffing company that specializes in the recruitment,...

  • Advanced Care Paramedic

    20 hours ago

    Chardon, United States University Hospitals Full time

    Job DescriptionDescriptionPosition SummaryThe Advanced Care Paramedic is responsible for providing lifesaving and advanced interventions to patients at on-site locations and/or during transport. Serves as the principal paramedic for specialty care and ALS transports. This position requires a team based approach where the paramedic is expected to have at...

  • Advanced Care Paramedic.UHHS EMS Institute-14130

    20 hours ago

    Chardon, United States University Hospitals Full time

    Job DescriptionDescriptionPosition SummaryThe Advanced Care Paramedic is responsible for providing lifesaving and advanced interventions to patients at on-site locations and/or during transport. Serves as the principal paramedic for specialty care and ALS transports. This position requires a team based approach where the paramedic is expected to have at...

  • Travel Nurse

    Found in: Talent US A C2 - 2 days ago

    Chardon, United States MedUS Healthcare Full time

    MedUS Healthcare is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Chardon, OH. Shift: 3x12 hr days Start Date: 06/02/2024 Duration: 13 weeks Pay: $1681 / Week About MedUS Healthcare:MedUS Healthcare, formerly Axis Providers, is a Joint Commission certified staffing company that specializes in the recruitment,...

  • Travel Nurse

    Found in: Talent US A C2 - 2 weeks ago

    Chardon, United States MedUS Healthcare Full time

    MedUS Healthcare is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Chardon, OH. Shift: 3x12 hr days Start Date: 06/02/2024 Duration: 13 weeks Pay: $1791 / Week About MedUS Healthcare:MedUS Healthcare, formerly Axis Providers, is a Joint Commission certified staffing company that specializes in the recruitment,...

  • Assistant Nurse Manager

    Found in: beBee S US - 3 weeks ago

    Chardon, United States University Hospitals Full time

    DescriptionPosition SummaryTo maintain the nursing staff in all areas as well as to deliver safe efficient age specific nursing care to patient/families. Essential FunctionsRoutinely provide patient care.Collaborate with the interdisciplinary team.Maintains employee records.Identifies needs for and provides Staff education/staff development.Participates in...

  • Pharmacy Manager

    Found in: Lensa US P 2 C2 - 7 days ago

    Chardon, United States University Hospitals Full time

    This Pharmacy Leadership role will have oversight of both TriPoint Medical Center and Beachwood Medical Center. The Pharmacy Manager, is responsible for planning, monitoring, and directly supervising pharmacy personnel in the safe, effective, and cost-effective acquisition & use of medications. Directing pharmacy operations, strategies, policies &...

  • Medical / Health - Nurse

    Found in: Jooble US O C2 - 3 days ago

    Chardon, OH, United States TravelNurseSource Full time

    TravelNurseSource is working with Lancesoft Inc to find a qualified OR RN in Chardon, Ohio, 44024! Pay Information $1,915 per week About The Position We are currently seeking qualified candidates for RN Position Details: Location Chardon, OH Shift 5x8 Days Duration of Assignment 90 Day 1 Medical, Health, Dental, Vision. $500 Referral Bonus...