Utilization Review Nurse

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary :

This position facilitates utilization management processes to support the right care is provided at the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization and readiness for care transition; assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays / issues as necessary; in collaboration with the care team. This position provides third-party payers clinical information to assure reimbursement; and coordinating care with the treatment team, patient, family, and others. Communicates with physicians for appropriate documentation to support authorization of services.

Responsibilities :

Patients / Families, Hospital staff, Medical staff, Community agencies, and Insurance Companies are served by conducting interpersonal relationships in a manner that projects a positive image of the department and hospital. All contacts with customers are friendly, helpful and courteous.

Other information : Qualifications

EDUCATION REQUIREMENTS

• Graduate from an accredited school of nursing, BSN preferred.

PROFESSIONAL EXPERIENCE REQUIREMENT

LICENSURE / REGISTRATION / CERTIFICATION

KNOWLEDGE, SKILLS AND ABILITIES REQUIREMENTS

PHYSICAL REQUIREMENT

Job Details

Legal Employer : Lenoir Health

Entity : UNC Lenoir Health Care

Organization Unit : Care Management

Work Type : Full Time

Standard Hours Per Week : 40.00

Salary Range : $32.48 - $38.98per hour (Minimum to Midpoint )

Pay offers are determined by experience and internal equity

Work Assignment Type : Onsite

Work Schedule : Day Job

Location of Job : US : NC : Kinston

Exempt From Overtime : Exempt : No