Utilization Management Nurse -Case Management, Per Diem Days

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Jefferson Health
Published
December 2, 2019
Location
Stratford, New Jersey
Job Type
PRN  

Description

 

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Utilization Management Nurse -Case Management, Per Diem Days, Stratford, NJ
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Job ID

9235716

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Responsibilities

  • GENERAL SUMMARY
    • The Utilization Management Nurse provides clinically based utilization management tasks to support the delivery of effective and efficient patient care. Has the overall accountability for the utilization management for patients within the assigned caseload. Collaborates with other members if the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilizes criteria to confirm medical appropriateness for the admission and continued stay. Responsible for assuring high quality, cost efficient medical outcomes for those patients identified as having the need for inpatient hospital or observation services. Responsible for screening patients for referral to Social Work and/or Care Transition Nurse.
  • MINIMUM KNOWLEDGE, SKILLS & ABILITIES
    • BSN preferred with 3-5 years of case management experience, including discharge planning and emergency department. RN license within the State of New Jersey Knowledge of managed care, government payers and third-party reimbursement. Must be proficient with InterQual and MCG criteria and its application. Schedule: This position requires 12 hour shifts and weekend rotation. Skills: Proficient with EDIS, SoftMed, Soarian and utilization of MS Office applications Developing and maintaining strong interpersonal relationships Ability to: Handle multiple tasks and projects simultaneously Collaborate with others to meet multiple deadlines Communicate effectively orally and in writing Document in an electronic health records Work in a team environment

Closing Statement

Jefferson Health delivers state of the art healthcare services to patients throughout the Delaware Valley and southern New Jersey. Jefferson (Philadelphia University + Thomas Jefferson University) provides more than 8,400 full and part-time students from nearly 40 states and 40 countries with 21st century professional education. Combined, we have over 30,000 employees.

 

Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in eight specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.

 

Thomas Jefferson University has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this unique model, we are preparing our students for current and yet to be imagined careers.

 

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.

 

 

 

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