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Utilization Review Coordinator

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POST DATE 9/17/2016
END DATE 12/13/2016

Prestige Care, Inc Renton, WA

Renton, WA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Entry Level (0 - 2 years)
Associates Degree


RN with prior MDS experience preferred. $3000 sign on bonus!

Job Summary:

Utilization Review Coordinators provide and plan the daily nursing activities and care as prescribed by the physician and in accordance with accepted standards of nurse practice and regulations. Promotes a positive physical and psychosocial environment for the residents.

Essential Functions:

Daily processes, coordinates and schedules MDSs and completes initial admissions along with RAPS and periodically as assigned.
Assists RCM with new admissions, transfers, and discharges ensuring related documentation is current, signed, and the recordkeeping meets the policies and procedures.
Every other day reviews PPS and OBRA schedule monitoring work assignments, providing feedback, evaluating performance, redirecting staff, and informs Director of Nursing Services of pertinent problems timely.
Ensures that optimal RUG scores are obtained and coordinates with head of therapy on a daily basis.
Reviews and completes resident records and related documentation in a timely manner, including the completion of nursing assessment for each resident within 14 days of admission.
Attends Triple Check on a monthly basis ensuring accurate billing for services. Directs the MCR and therapy meeting on a weekly basis.
Coordinates with the RCM and therapy staff to assess and review the level of care for HMO patients, advocating for the patient with the insurance companies. On a timely basis obtains authorizations from the HMOs for each patient to receive care.
Processes patient certifications and re-certifications and obtain the necessary signatures.
Documents all pertinent information in the interdisciplinary notes and on the 24-hour DNS report form timely and accurately.
Performs other related duties as assigned.

Must have a current, unencumbered LPN/LVN or RN license.
LPN certificate, Associate Degree in Nursing, or Bachelor of Science in Nursing.
Minimum of 1 year working in geriatric nursing, including experience with medication administration, delivery systems and pharmacies.
One year in supervisory/management position, with experience with budgets, staff development, training and scheduling.
Additional course work in management an asset.
Excellent written and oral communication and motivational skills are essential to success.
Ability to creatively problem solve in both resident care and employee management situations.
Individual must be a team player, well organized, and flexible.

At Prestige, we offer a dynamic and collaborative environment where you will not only make a difference in the lives of others every day; you have the opportunity to grow professionally, learn new skills and advance your career. Prestige Care offers a comprehensive benefit package including:
Medical, Dental and Vision PlansHSA/FSA AccountsEmployer Paid Group Life and ADD insurance401(k) plan with w/Company MatchGenerous Paid Time Off/Vacation TimeContinuing Education and Professional Development ProgramsScholarship/Tuition Reimbursement ProgramEmployee Discounts: Cell Service, Theme Parks and much more!