Emergency Department Utilization Review Registered Nurse, 9 : 00AM-5 : 30PM, with some holiday and weekend on-call coverage

Under general supervision, provides consultative support to the admitting teams concerning patient status determinations and utilization of resources for patients requiring hospital services. Works collaboratively with interdisciplinary teams facilitating appropriate status determinations through the utilization review process supporting quality, cost-effective patient outcomes. Responsible for analyzing clinical information and performing timely initial and concurrent reviews using InterQual screening software.

Education

Bachelor of Science in Nursing (BSN) OR Associate of Science in Nursing and currently enrolled in a BSN program with an expected graduation date within three (3) years.

Experience

Five (5) years diversified, progressive experience in acute care and / or other settings within the continuum required.

Two (2) years of Utilization Management experience which includes utilization review processes and discharge planning preferred.

Knowledge, Skills and Abilities

• Advanced knowledge of InterQual and / or MCG admission criteria
• Knowledge of healthcare regulatory standards
• Advanced skill in using computer software
• Advanced skill in oral and written communication
• Advanced skill in critical thinking
• Ability to work independently and resolve complex problems
• Ability to remain calm under pressure and intense time constraints
• Strong analytical and problem solving skills
• Strong interpersonal communication skills
• Strong organizational and time management skills
• Proficiency in electronic medical record review

Licensures, Certifications

Physical Requirements

Working Conditions

Conditions of Employment

Maintain current licensure

Principal Duties and Responsibilities

knowledge of national and local coverage determinations to appropriately advise physicians.

systems, and business support applications.

All roles must demonstrate GBMC Values :

Respect

I will treat everyone with courtesy. I will foster a healing environment.

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

Teamwork

I will be engaged and collaborative. I will keep people informed.

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

Pay Range

$66,292.41 - $107,062.33

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.