Utilization Review Nurse: Care Coordination

Kern Medical; Bakersfield (CA); In loco; USD 60.000 - 94.000; Tempo pieno

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Descrizione del lavoro

Kern Medical, Bakersfield, CA, is seeking a Utilization Review Nurse to support discharge planning and utilization review for in-patient admissions. The role requires reviewing medical records, coordinating with payors, and advising on documentation to maximize appropriate utilization of hospital resources.

Responsibilities include ongoing care reviews with attending physicians, documenting discharge plans, and ensuring compliance with regulatory requirements and hospital policies.

Competenze

• RN licensed in California.
• Two years RN experience in an acute care hospital setting, incl. med/surg.
• Familiar with payor requirements and discharge planning.

Mansioni

• Obtains and evaluates medical records for inpatient admissions to determine documentation is present.
• Coordinates with payor sources and initiates advisories as needed for appropriate utilization.
• Performs ongoing reviews and discusses care changes with physicians and staff.
• Formulates and documents discharge plans and coordinates with hospital services.

Conoscenze

Utilization review

Discharge planning

Medical chart review

Regulatory knowledge

Formazione

California RN license

Descrizione del lavoro

Kern Medical, Bakersfield, CA, is seeking a Utilization Review Nurse to support discharge planning and utilization review for in-patient admissions. The role requires reviewing medical records, coordinating with payors, and advising on documentation to maximize appropriate utilization of hospital resources.

Responsibilities include ongoing care reviews with attending physicians, documenting discharge plans, and ensuring compliance with regulatory requirements and hospital policies.