UTILIZATION MGMT/DISCHARGE PLANNER RN (PCN 2990)
Work Hours: M-F Days
STARTING SALARY: $40.73 - $42.59/hr and up, depending on experience.
The Utilization Management/Discharge Planner RN position assist with ensuring the placement and provision of cost-effective, best practice, health care services. The UM/UD RN will use clinical expertise and discretion to apply specialized case and utilization management methodologies and practice to ensure medical appropriateness criteria is met and level of care provided is documented. They will work and collaborate with the Discharge Planning Team to identify patients that are high-risk financial, clinical and social cases they will perform concurrent reviews. Interacts with physicians, nursing, and ancillary staff to promote accurate documentation. They will use various methods to manage these goals, including written and oral communications, committees, and councils, while working closely with staff in the Health Information Management, Patient Financial Services and Quality/Risk Departments as well as physicians, nurses, social services, auxiliary staff and South Peninsula Hospital (SPH) Senior Management Team.
KNOWLEDGE, SKILLS AND EXPERIENCE:
The position of UM/DP RN requires that they possess the minimum of a degree in nursing, BSN preferred, and a current license to practice as a registered nurse in the state of Alaska. A minimum of 3+ years of experience in an acute care hospital setting with 2-3 years of utilization management preferred; certified in Basic Life Saving through the American Heart Association.
The Utilization Management RN must have a thorough knowledge of Utilization Management, including, but not limited to: knowledge of regulatory standards and procedures relative to utilization and case. Management issues including the DRG-based reimbursement system; a thorough knowledge of third party reimbursement and methods of payment by insurance carriers; a basic knowledge of ICD-9/10 coding; and basic knowledge of the functions of all hospital departments.
Effective speaking, listening, presenting, and writing skills are required to communicate with the medical staff and with personnel at all levels. Have effective skills in the organization and prioritization of work. Demonstrate flexibility and the ability to change; exercise good judgment and able to cope with stressful situations; positive attitude and team player. At the same time, must be able to function independently and be thorough, accurate and objective in generation of reports. Ability in business math and basic statistical analysis is required for data completion, dashboards analyses and presentation of conclusions with UR Team input/support. Must be computer-literate and able to use word processing, spreadsheets, databases and presentation software; able to maintain a high degree of confidentiality is mandatory. Passion for quality, learning, analysis and teaching.
NATURE AND SCOPE:
This is a confidential, non-exempt position. Will report to the Director of Acute Care and works with the CFO and CNO, respectively. The Utilization Management/Discharge Planner RN assists the CEO, Quality Director, Medical Staff, and Allied Practitioners to meet their obligations to the Board of Directors to provide high quality, cost-effective health care. They will coordinate regularly UR Meetings with these leaders and an appointed Physician liaison to review Hospital performance, processes, patient placement issues, payment updates, and regulatory standards.
South Peninsula Hospital is a 22 bed critical access hospital (CAH) located on the southern end of the Kenai Peninsula. There is a 28 bed long term care facility attached to the hospital.
We offer highly competitive wages and benefits including: health/dental/vision/life insurance, 403b retirement plan, health and wellness reimbursement, loan forgiveness, generous paid leave and relocation bonus (for applicable applicants). Apply today!
Homer, Alaska, is a seaside town nestled on the shores of beautiful Kachemak Bay, offering breathtaking views of glaciers, mountains and wildlife. If you are looking for community, adventure, culture, scenery or solitude, you'll find all of that and more here!