This Utilization Review Nurse (UR RN) position requires providing utilization review services. The role involves assessing patient needs, collaborating with healthcare providers, and ensuring appropriate resource allocation. The position requires a minimum of two years of experience in a hospital, home health, or hospice setting.
Location: Apple Valley, California, United States,
Responsibilities:
- Conducting utilization reviews to determine medical necessity and appropriateness of care.
- Collaborating with physicians, case managers, and other healthcare professionals to coordinate patient care.
- Analyzing patient data to identify trends and areas for improvement in resource utilization.
- Developing and implementing strategies to improve the efficiency and effectiveness of healthcare services.
- Maintaining accurate and up-to-date records of utilization review activities.
- Adhering to all applicable regulations and guidelines related to utilization review.
- Patient assessments
- Medication administration
- Treatment planning
- Collaboration with the interdisciplinary team
Required Skills & Certifications:
- Active Registered Nurse (RN) license in the state of employment.
- Bachelor's degree in Nursing or related field.
- Minimum of two years of experience in hospital, home health, or hospice care.
- Clinical assessment, medication administration, and treatment planning skills.
- Interdisciplinary team collaboration skills.
- Excellent communication and interpersonal skills.
- Ability to work effectively in a fast-paced environment.
- Driver's license, car insurance, and automobile for field work (if applicable).
Preferred Skills & Certifications:
- Experience in utilization review or case management.
- Knowledge of healthcare regulations and guidelines.
- Proficiency in electronic health record (EHR) systems.
Special Considerations:
- Weekend work is required: 4 weekend shifts (days) in a six-week period, with the possibility of more.
- This is a 16-week assignment.
Scheduling:
- Day shifts on weekends, with a minimum of 4 shifts every six weeks. The exact schedule will be determined by the employer.
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