PRN ED Utilization Management Nurse (Remote)

Description Standard need will be to cover shifts associated with PTO, typical shift is 10P-10A

What You Will Do

Expectations: Ability to cover shifts to assist with coverage of PT and FT nurses taking PTO. Assignments: managing recommendation of patients being admitted to the hospital setting using criteria set (MCG and IQ) we are willing to teach.

• Collaborates and coordinates with reputed company members of the health care team, patient and family (or significant others) to coordinate and ensure timely and efficient delivery of required workflow, services and tasks to result in:
• Support of positive patient health care reputed company
• Increased patient/health care team reputed company and satisfaction
• Improved inpatient throughput and appropriate length of stay
• Improved communication, awareness and adherence to regulatory requirements associated with utilization
• Support for inappropriate level of care and decreased inpatient bed day denials
• Continuity and coordination of care
• Appropriate and timely authorization for level of care
• Decreased denials
• Appropriate reimbursement
• Performs and documents timely and accurate reputed company review of records and discusses plan of care with ED physicians to support the decision making process with regard to LOC reputed company inpatient admission or outpatient observation services. (60%)
• Supports effective and timely communication of the physician decision regarding inpatient admission or outpatient observation services for accurate registration status, and delivery of appropriate notices to patient reputed company required (ie IMM delivered by registration staff).
• Conducts reputed company CM activities with a focus on reputed company quality improvement in a manner that is supportive of UHC quality initiatives and in compliance with applicable regulatory requirements.

Additional Responsibilities

• Performs other duties as assigned.
• Complies with reputed company policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by reputed company requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in reputed company to address appropriate use of PHI in the workplace.

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