Utilization Review RN: Discharge Planning Pro

Madera Community Hospital; Madera (CA); On-site; USD 75,000 - 95,000; Full time

Job summary

Madera Community Hospital in California is seeking a Utilization Review Nurse to assess, plan, implement, and evaluate patient needs for discharge and utilization review processes. The role involves working closely with patients, families, physicians, and nursing staff to ensure seamless discharge planning.

Candidates must possess at least 1-3 years of relevant health-care experience, a valid California RN license, and the ability to provide exceptional customer service in a collaborative environment.

Qualifications

• Minimum of 1-3 years of related acute health-care experience.
• Working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
• Ability to maintain collaborative working relationships.
• Ability to plan and prioritize work with frequent interruptions.
• Ability to provide exceptional customer service.

Responsibilities

• Assess, plan, implement and evaluate patients' needs for discharge planning.
• Coordinate discharge planning with physicians and nursing staff.
• Perform utilization review procedures including knowledge of insurance criteria.

Skills

Customer service

Verbal communication

Written communication

Collaboration

Prioritization

Education

Completion of an accredited nursing program

Current California Board of Nursing Registered Nurse License

Current American Heart Association BCLS certificate

ACLS certificate preferred

CCM in Case Management preferred

Tools

Hospital information technology applications

Job description

Madera Community Hospital in California is seeking a Utilization Review Nurse to assess, plan, implement, and evaluate patient needs for discharge and utilization review processes. The role involves working closely with patients, families, physicians, and nursing staff to ensure seamless discharge planning.

Candidates must possess at least 1-3 years of relevant health-care experience, a valid California RN license, and the ability to provide exceptional customer service in a collaborative environment.