Join our Talent Network

RN Utilization Management Post Acute Reviewer

Job ID: 19801
Facility: CHAPS Building
City: Greensboro

Date Posted: 2021-06-17 06:44:57 UTC
2021-05-18 06:43:22 UTC

Share:

Job Description

LOCATION: CHAPS Building, THNM-THN Utilization Managemnt
CITY: Greensboro, NC

JOB DETAILS:
Exempt: Yes | FTE: 1.0 (40 hours/week) | Schedule: Monday - Friday, first shift, on call every 10 weeks | On Call: Yes

JOB SUMMARY:

Accountable for coordinating, authorizing, monitoring and reporting all Post-Acute Inpatient Utilization Management activities. Works in tandem with RN Team Lead and physician reviewers for NOMNC, DENC and appeals for post-acute inpatient members. Provides routine on site visits to members in post-acute settings to ensure that high level appropriate services are being provided and coordinate post discharge care needs. Works in collaborative practice with the physician and other members of the health care team to meet patient-specific and age-related patient needs, linking cost resource management and quality to patient care. Demonstrates proficiency in the application of national and local clinical case review criteria and appropriate levels of care across the care continuum for managing complex cases and related episodic care events
Completes established competencies for the position within designated introductory period. Develops strong working relationships with Post-Acute Providers.

EDUCATION:

Required: Graduate of accredited School of Nursing

Preferred: Bachelors

EXPERIENCE:

Required:
• Three (3) year's experience in Utilization Review, Discharge Planning and Medical Case Management in a post-acute care setting.
• MDS certification highly desirable.
• Strong organizational skills.
• Knowledge of specific regulatory, managed care requirements related to NOMNC and DENC processes.

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

REQUIRED
Valid Driver's License | Valid Driver's License
Required: Current North Carolina License for Registered Nurse

Preferred: Bachelors or Master's Degree in Nursing; MDS certification

Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our team at 866-266-3767 to request an accommodation.
Share:

Similar Jobs

RN OB Specialty Care - Weekends

Greensboro
Moses Cone Hospital

LPN Hosp MHC I/P Rehab

Greensboro
Moses Cone Hospital

RN (Registered Nurse)

Greensboro
Moses Cone Hospital

RN Float MC Flexible Resources

Greensboro
Moses Cone Hospital

RN Flex Resources

Greensboro
Moses Cone Hospital

RN Unit Based Per Diem

Greensboro
Moses Cone Hospital

RN Campus Based Per Diem

Greensboro
Moses Cone Hospital

RN Campus Based Per Diem

Greensboro
Moses Cone Hospital

RN - Moses Cone Urgent Care Center

Greensboro
Cone Health Urgent Care

RN Cardiovascular - MHC - 7a - 7p

Greensboro
Moses Cone Hospital

RN PICU

Greensboro
Moses Cone Hospital

RN Cardiovascular 7p-7a

Greensboro
Moses Cone Hospital

RN Cardiovascular - 7p-7a

Greensboro
Moses Cone Hospital

RN - Elink (Weekends Only)

Greensboro
Cone Health

RN - Cardiac Cath Lab

Greensboro
Moses Cone Hospital

RN - Cardiac Cath Lab Recovery

Greensboro
Moses Cone Hospital

RN - Cardiac Cath Lab (Per Diem)

Greensboro
Moses Cone Hospital

RN L&D

Greensboro
Moses Cone Hospital

RN L&D

Greensboro
Moses Cone Hospital

RN WL 5E Medical

Greensboro
Wesley Long Hospital

RN Nephrology

Greensboro
Moses Cone Hospital