Registered Nurse Care Manager - RN - Utilization Review PRN 9/9/2016
JOB DESCRIPTIONAPPLY Saint Joseph Hospital is part of SCL Health, a faith-based, nonprofit health care organization.
Interested in making a difference? Then check us out. Our rich heritage and mission, and our focus on health care delivery that values person-centered care, excellence and accountability are a winning combination as we bring health and hope to our patients.
* Denver (estab.1873)
* Largest acute care provider in Denver area
* 2,397 associates, 1,332 medical staff, 108 residents
* 371 beds
* New $623 million, 360-bed, 826,000-square-foot replacement facility (December 2014)
Services & Expertise
* Breast Care Center
* Cardiovascular Services
* Center for Women and Infants
* Comprehensive Cancer Center
* Emergency Services
* Medical Imaging
* Plastic & Reconstructive Surgery
* Surgical Care
* Weight Loss Surgery Center
Kudos: Saint Joseph Hospital offers excellence across the continuum of care for patients.
The RN Care Manager reviews requests for authorization and monitor care during authorized periods of stay for levels of care. Reviews patients' medical charts to ascertain the medical necessity for services and the appropriateness of level of care.
* Conduct on-site review of medical records at clinical facilities according to organization standards.
* Maintain frequent telephone contact with clinical service providers to perform defined duties and facilitate communication between the organization and the provider.
* Document UR/case management activities such as precertifications, concurrent and retrospective reviews.
* Consult regularly with other organization staff to review treatment plans when level of clinical care requires further clarification.
* Maintain a tracking system and clear, concise records for monitoring and reviewing cases.
* Prepare documentation/case synopsis upon closure of cases as required by clients.
* Provide phone crisis intervention services and precertification evaluations for inpatient hospitalization and other levels of care.
* Provide consultation and training to providers regarding authorization procedures and utilization review for a specific course or nature of treatment.
* Contribute to policy review and procedure development and evaluation.
* Performs other duties as assigned, some of which may be essential to the job.
The information above is for summary purposes, and is not intended to be a comprehensive list of essential functions.
* Graduate of an accredited school of nursing
* BSN required within 5 years of employment
* Current RN license in the state of CO
* Minimum of three years clinical nursing experience in an acute care setting
* Knowledge and experience with managed care
* Three years case cmnagement experience in an acute care setting using evidence-based criteria for screening medical necessity
SCL Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.