Utilization Review Case Manager – Home Care

Dartmouth-Hitchcock; White River Junction (VT); Remote; USD 75,000 - 90,000; Full time

Job summary

Dartmouth-Hitchcock is seeking a Utilization Review Case Manager for Home Health to provide patient care coordination and management in a flexible work setting. Ideal candidates will have a nursing background, experience in home health, and a thorough understanding of Medicare regulations, alongside the ability to work independently while collaborating with interdisciplinary teams. This is a per-diem position that offers significant work-life balance and an opportunity to make a positive impact on patients' lives.

Benefits

Employee Referral Bonuses

Clinical CEUs

Online LinkedIn Learning

Qualifications

• Unencumbered RN License in both VT and NH or active compact license.
• Minimum of 2 years’ experience in Home Health.

Responsibilities

• Coordinates and manages the patient’s plan of care.
• Collaborates with primary clinician to create a plan for the patient’s care.
• Continuously reviews the patient’s plan of care throughout the episode.

Skills

Knowledge of Medicare regulations

Experience with Electronic Medical Records

Proficient in Excel

Proficient in Word

Education

Graduate of an accredited school of nursing

Job description

Utilization Review Case Manager – Home Health
PRN, Days

Why work as a Utilization Review Case Manager at Visiting Nurse and Hospice for Vermont and New Hampshire?

• You experience satisfying and challenging work that makes a difference, every day.
• You really get to know your patients and become an integral part of their care team.
• You are provided broad independence but are also part of a cohesive interdisciplinary team.
• You get to be an important part of the community where you live.
• You have a work/life balance that can match the flexibility you need.

Benefits include:

• Employee Referral Bonuses
• Clinical CEUs
• Online LinkedIn Learning

Schedule:

• Mondayand Fridayare eight-hourshiftswith one 4-hour flex shift to be discussed with hiring manager.

Locations:

• Fully remote work in all states except: CA, CT, MA, MD, NJ, NY, OH, RI, WY.

Visiting Nurse and Hospice for VT & NH covers more than 70 towns, delivering superior nursing, rehabilitation, hospice, and personal care services with proven effectiveness, integrity, and compassion. Our only goal is to help the people in our communities. When you join Visiting Nurse and Hospice for VT & NH, you’ll become part of a dedicated team delivering outstanding home health and hospice services that enrich the lives of the people we serve.

Utilization Review Case Managers at VNH focus on providing pain management and comfort for patients with terminal or chronic illnesses, as well as communicating and coordinating care needs with the interdisciplinary team, the patient and their families/caregivers.

The URCM:

• Collaborates with primary clinician, provider, patient, their family and/or the primary care givers upon admission to create a plan for patient’s care.
• Continuously reviews the patient’s plan of care and collaborates with primary clinician throughout patient’s episode to ensure the patient’s plan of care aligns with care being provided.
• Coordinates and manages the patient’s plan of care, including but not limited to: order review, resource management, measuring outcomes, and communication and collaboration with patient, caregiver and attending provider.
• Collaborates with primary clinician in identifying need for referral for interdisciplinary services.
• Utilizes key performance indicators associated with value-based purchasing, patient driven grouping models, and patient satisfaction to guide patient care and utilization.
• Completes clinical review of referrals and collaborates with the intake and referral teams.

Minimum Qualifications:

• Graduate of an accredited school of nursing.
• Unencumbered RN License in both VT and NH or active compact license.
• Demonstrated knowledge of Medicare regulations and Medicare Conditions of Participation (CoP).
• Minimum of 2 years’ experience in Home Health
• Experience with Electronic Medical Records
• Proficient in Excel and Word systems

We would love to meet you and tell you more about this engaging and fulfilling part of our healthcare delivery system. Our recruiters can explain the different roles, our service area, the unique aspects of home and hospice care, and the many benefits we can offer your career and personal life.

Visiting Nurse and Hospice for Vermont and New Hampshire (VNH) will never require candidates to provide personally identifying information such as social security number, date of birth, street address, or banking information in order to submit an application for employment. Identifying information will only be requested after an offer of employment has been extended and accepted, for the purposes of security screening and onboarding. If you experience a request for your personal information prior to acceptance of an offer of employment, please contact VNH’s Human Resources Department immediately at 888.300.8853 or [e-mail].

As part of Dartmouth Health, Visiting Nurse and Hospice for VT & NH is an equal-opportunity employer.

• Area of Interest: Nursing (Other);
• Work Status: Monday, Friday and one Flex Day;
• Employment Type: Per Diem;
• Job ID: 1474

Dartmouth Health is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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