Specialist (Part-time) - Utilization Management

Penn State Health; Hershey (PA); On-site; USD 80,000 - 105,000; Full time

Benefits offered by this job

75% Tuition Discount for employee and

Total Rewards Program

Be Well wellness programs and fitness/

Job summary

Penn State Health Milton Hershey Medical Center in Hershey, PA, is seeking a nurse reviewer to authenticate admissions by comparing EMR documentation against evidence-based criteria. The role includes concurrent/continued stay reviews and ensuring CMS Condition of Participation compliance for Utilization Management.

Minimum qualifications include a Bachelor's or Master's in Nursing, three years of advanced clinical hospital experience, and an active RN license (PA or multi-state via the NLC).

Qualifications

• Bachelor's in Nursing or Master's in Nursing required.
• Three years of advanced clinical hospital experience required.
• Currently licensed as RN in Pennsylvania or multistate license through the nurse licensure compact (NLC).

Responsibilities

• Review clinical documentation in the EMR to certify admissions.
• Perform concurrent/continued stay review as appropriate.
• Maintain compliance with CMS Conditions of Participation for Utilization Management.

Skills

Advanced clinical nursing

Education

Bachelor's Degree in Nursing

Master's Degree in Nursing

Job description

Invest in Your Future and Theirs:

Full-time Milton S. Hershey Medical Center employees receive a 75% Penn State tuition discount for themselves and eligible dependents through the Grant-in-Aid program.

Penn State Health - Hershey Medical Center

Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally accepted and evidence-based criteria to certify an admission to the facility, and for concurrent/continued stay review as appropriate. Also responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management.

MINIMUM QUALIFICATION(S):

• Bachelors Degree in Nursing or Masters Degree in Nursing required.
• Three (3) years advanced clinical experience in a hospital setting required.
• Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN license through the interstate Nurse Licensure Compact.

PREFERRED QUALIFICATION(S):

• Financial Counseling experience preferred.

WHY PENN STATE HEALTH?

Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.

Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:

• Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
• Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
• Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
• Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
• Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.

WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?

Penn State Hershey Medical Center is Central Pennsylvania's only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.

YOU TAKE CARE OF THEM. WE'LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence - that's Penn State Health. But what makes our healthcare award-winning? That's all you.

This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.

Penn State Health is an Equal Opportunity Employerand does not discriminate on the basis of any protected class including disability or veteran status. Penn State Health's policies and objectives are in direct compliance with all federal and state constitutional provisions, laws, regulations, guidelines, and executive orders that prohibit or outlaw discrimination.