Utilization Management RN - Manager
Company: UC Health
Location: Aurora
Posted on: May 22, 2023
|
|
Job Description:
Utilization Management RN Apply now Save job Saved Description
Summary: Ensures that services are delivered and documented in a
manner that balances quality of care with efficiency,
cost-containment and compliance. Work Schedule: Full Time Days/20
hours per week. Responsibilities: Reviews admissions and service
requests within assigned unit for prospective, concurrent, and
retrospective medical necessity and/or compliance with
reimbursement policy criteria. Provides case management and/or
consultation for complex cases. Assists departmental staff with
issues related to Milliman (or similar) guidelines, status
determination, medical records/documentation, precertification,
reimbursement and concurrent denials appeals. Collaborates closely
with case managers to make sure status' and level of care is
accurate. Communicates with payers as needed to ensure patient
accounts are secured. Assesses and coordinates patient's discharge
planning needs with members of the healthcare team. Within scope of
job, requires critical thinking skills, decisive judgement and the
ability to work with minimal supervision. Must be able to work in a
fast-paced environment and take appropriate action. Requirements:
Credentials: Essential: Registered Nurse Other information: Minimum
Required Education: Bachelor's degree in Nursing. Required
Licensure/Certification: State licensure as a Registered Nurse
(RN). Minimum Experience: Five years of experience as a utilization
manager and five years as an RN in the assigned clinical area, with
demonstrated clinical competence. This clinical experience must
have taken place within the last five years of the nurse's career.
The pay range for this position is: $36.47 - $56.52 / hour. Pay is
dependent on applicant's relevant experience. UCHealth offers a
Five Year Incentive Bonus to recognize employee's contributions to
our success in quality, patient experience, organizational growth,
financial goals, and tenure with UCHealth. The bonus accumulates
annually each October and is paid out in October following
completion of five years' employment. UCHealth offers their
employees a competitive and comprehensive total rewards package:
Full medical, dental and vision coverage Retirement plans to
include pension plan and 403(b) matching Paid time off. Start your
employment at UCHealth with PTO in your bank Employer-paid life and
disability insurance with additional buy-up coverage options
Tuition and continuing education reimbursement Wellness benefits 5
year incentive bonus Full suite of voluntary benefits such as
identity theft protection and pet insurance Education benefits for
employees, including the opportunity to be eligible for 100% of
tuition, books and fees paid for by UCHealth for specific
educational degrees. Other programs may also qualify for up to
$5,250 pre-paid by UCHealth or in the form of tuition reimbursement
each calendar year Loan Repayment: UCHealth is a qualifying
employer for the federal Public Service Loan Forgiveness (PSLF)
program! UCHealth provides employees with free assistance
navigating the PSLF program to submit their federal student loans
for forgiveness through Savi. At UCHealth, we do things differently
We believe in something different: a focus on the individuality of
every person. In big ways and small, we exist to improve the
extraordinary lives of all those we serve. As Colorado's largest
and most innovative health care system, we as a team deliver on the
commitment to provide the best possible experience for our patients
and their families. We foster a true human connection and give
people the freedom to live extraordinary lives. A career at
UCHealth is more than a job, it's a passion. Going beyond quality
requires the perfect balance of talent, integrity, drive and
intellectual curiosity. We are looking for individuals who
recognize, like us, that the world of medicine is ever-changing and
are motivated to do what is right, not what is easy. We support
creativity and curiosity so that each of us can find the
extraordinary qualities within ourselves. At UCHealth, we'll do
everything in our power to make sure you grow and have a meaningful
career. There's no limits to your potential here. Be Extraordinary.
Join Us Today! UCHealth recognizes and appreciates the rich array
of talents and perspectives that equal employment and diversity can
offer our institution. As an affirmative action/equal opportunity
employer, UCHealth is committed to making all employment decisions
based on valid requirements. No applicant shall be discriminated
against in any terms, conditions or privileges of employment or
otherwise be discriminated against because of the individual's
race, creed, color, religion, gender, national origin or ancestry,
age, mental or physical disability, sexual orientation, gender
identity, transgender status, genetic information or veteran
status. UCHealth does not discriminate against any "qualified
applicant with a disability" as defined under the Americans with
Disabilities Act and will make reasonable accommodations, when they
do not impose an undue hardship on the organization. Share:
Keywords: UC Health, Aurora , Utilization Management RN - Manager, Executive , Aurora, Colorado
Click
here to apply!
|