Utilization Review RN - Case Management Expert

North Vista Hospital; North Las Vegas (NV); Presencial; USD 85.000 - 110.000; Jornada completa

Descripción de la vacante

North Vista Hospital in North Las Vegas, NV is seeking a registered nurse with strong case management skills to optimize patient flow and resource use. This full-time role focuses on admission review, discharge planning, and coordination across care teams to ensure quality and cost-effective outcomes.

The ideal candidate has a minimum 5 years of nursing experience post-graduation, plus at least 1 year in case management or discharge planning, and demonstrated computer proficiency.

Formación

• Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
• At least one year experience in case management, discharge planning or nursing management
• Experience and knowledge in basic to intermediate computer skills.

Responsabilidades

• Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
• Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.
• The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Conocimientos

Case management

Discharge planning

Nursing leadership

Clinical documentation

Educación

RN license

Herramientas

Milliman Criteria

InterQual Criteria

Descripción del empleo

North Vista Hospital in North Las Vegas, NV is seeking a registered nurse with strong case management skills to optimize patient flow and resource use. This full-time role focuses on admission review, discharge planning, and coordination across care teams to ensure quality and cost-effective outcomes.

The ideal candidate has a minimum 5 years of nursing experience post-graduation, plus at least 1 year in case management or discharge planning, and demonstrated computer proficiency.