RN - UTILIZATION MANAGEMENT - Aultman Hospital - Canton, OH

RN - UTILIZATION MANAGEMENT - Aultman Hospital - Canton, OH -

RN – UTILIZATION MANAGEMENT
Aultman Hospital 55 critiques – Canton, OH
Half-time

BSN Most popular

PURPOSE OF POSITION:
Collaborate with the RN Case Managers, Social Staff, and Precertification/Verification employees to offer crucial medical info to exterior payers to make sure providers and interventions are well timed and applicable in assembly the wants of the sufferers together with fulfilling monetary obligations.

WORKING CONDITIONS:
1. Works eight and/or 12 hours per day, adjusting hours to satisfy buyer wants
2. Have to be in good bodily and psychological well being and keep a superb attendance document
three. Should adhere to Hospital insurance policies and procedures
four. Should fulfill place description necessities
5. Is topic to frequent interruptions throughout efficiency of duties
6. Hazardous Publicity Class – 1
7. Should be capable of make the most of pc/phrase processing

JOB QUALIFICATIONS:
1. Present RN licensure within the State of Ohio.
2. Graduate of authorised Faculty of Nursing, BSN most popular
three. 5 years of nursing expertise within the acute care setting.
four. Certification in UR, Case Administration, High quality, or associated subject most popular.
5. Information of managed care ideas in relation to monetary elements of affected person care most popular.
6. Capable of work with all ranges of the multidisciplinary healthcare group particular to undertaking management.
7. Refined organizational expertise with nicely-developed fashion of diplomacy and assertiveness
eight. Refined communications expertise, each written and oral.

RESPONSIBILITIES AND EXPECTATIONS:
1. Respects sufferers’ rights and duties.
2. Is courteous in coping with all clients, whether or not exterior or inner.
three. Demonstrates compassion and sensitivity to all clients.
four. Exhibits respect for the client’s tradition, language, customs, and beliefs.
5. Maintains excessive normal of moral and professional conduct.
6. Actively participates in high quality enchancment actions inside the division
7. In a position to make use of crucial considering expertise, drawback fixing talents and an understanding of methods and alter course of.
eight. Capable of perform autonomously, displaying private integrity and all the time sustaining confidentiality.
9. Potential to cope with battle decision.
10. Demonstrates management expertise and the power to delegate duties.
11. Features within the position as affected person/household advocate intervening as wants point out.
12. Clothes in skilled method, sporting both lab coats or jackets when within the medical setting.
13. Makes use of obtainable instructional assets to take care of and develop information and expertise associated to area of apply.
14. Actively oversees task of Statement standing and manages standing points associated to this service
15. Demonstrates competency in Proof-Based mostly Tips (i.e. InterQual).
16. Oversees affected person’s medical progress to guarantee applicable degree of care, use of assets and well timed care supply.
17. Supplies info in order that exterior payer necessities are met to make sure reimbursement for the Hospital.
18. Identifies and participates within the improvement and implementation of methods to scale back pointless useful resource consumption and size of keep on assigned affected person inhabitants.
19. Screens delays in care and discharge, actively intervening as applicable to get rid of delays and supply well timed entry to care and providers.
20. Collaborates with medical employees and different members of the healthcare group to make sure efficient, environment friendly supply of care and providers.
21. Communicates, each verbal and written, submit hospital care wants and plan to all members of the healthcare workforce.
22. Features as useful resource to medical employees and Hospital employees relating to regulatory and payer necessities.
23. Features as workforce member, working intently with all members of the HDS Care Coordination Workforce. As well as, maintains working relationships with all Hospital workforce members.
24. Identifies alternatives for inter and intradepartmental operational enhancements
25. Offers cross-protection for workforce members as wanted.

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