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RN / Registered Nurse - Utilization Management - Per Diem - Days

Company: ProMedica Health
Location: Toledo
Posted on: March 15, 2019

Job Description:

Job Title
RN / Registered Nurse - Utilization Management - Per Diem - Days
Nurses - Acute
Organizational Unit
ProMedica - ProMedica System - PHS Corporate - Utilization Management (8729)
Toledo, OH 43606 US (Primary)
Job Description

Position Summary:

Utilization Management (UM) nurses work to maximize the quality and cost efficiency of health care services. Through regular reviews and audits, they ensure that patients receive the care they need without burdening the health care system with unnecessary procedures, ineffective treatments or extended hospital stays. The UM nurse reviews admissions for medical necessity and appropriate level of care. The UM nurse reviews clinical information for concurrent reviews, extending length of stay for in-patient as appropriate. The UM nurse ensures compliance with Medicare s Conditions of Participation (CoP s). The UM nurse must communicate with physicians frequently to discuss appropriateness of care. The UM nurse uses effective utilization management, resource management, education, patient advocacy and related interventions to: Promote cost effective medical outcomes, Prevent hospitalizations when possible and appropriate, and Promote decreased length of stay as appropriate. Job Requirements

* Must be a Registered Nurse from an accredited school of nursing with a minimum of three (3) to five (5) years of recent acute care nursing experience

* Must hold a current licensure as a registered nurse in the state of Ohio.

* BSN and previous UR/UM and/or CDMP experience preferred.

* Strong interpersonal skills required.

* Prefer previous experience with UR/UM/Case Management, discharge planning, CDMP.

* Knowledge of insurance guidelines, federal regulations and community resources preferred.

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. It serves communities in 30 states. The organization offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 70,000 employees, 13 hospitals, 2,700 physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and 450 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies. Driven by its Mission to improve your health and well-being, ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.

Equal Opportunity Employer/Drug-Free Workplace Employee Exemption Type
Job Type
Per Diem
Budgeted Hours / Pay Period
Shift Type
Shift Hours
8 hours
On-call Requirements

Additional Schedule Details
24 hours commitment per month. Depending on dept need, this could include weekend or holiday hours. Day shift hours, equal to or similar to 8:00am-4:30pm.

Keywords: ProMedica Health, Toledo , RN / Registered Nurse - Utilization Management - Per Diem - Days, Healthcare , Toledo, Ohio

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