About the role
%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:red;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EStandard need will be to cover shifts associated with PTO, typical shift is 10P-10A%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EWhat You Will Do%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EExpectations: Ability to cover shifts to assist with coverage of PT and FT nurses taking PTO.%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAssignments: managing recommendation of patients being admitted to the hospital setting using criteria set (MCG and IQ) we are willing to teach.%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECollaborates and coordinates with all members of the health care team, patient and family (or significant others) to coordinate and ensure timely and efficient delivery of required workflow, services and tasks to result in:%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Support of positive patient health care outcomes%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Increased patient/health care team outcomes and satisfaction%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Improved inpatient throughput and appropriate length of stay%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Improved communication, awareness and adherence to regulatory requirements associated with utilization%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Support for inappropriate level of care and decreased inpatient bed day denials%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Continuity and coordination of care%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Appropriate and timely authorization for level of care%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Decreased denials%26nbsp;%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Appropriate reimbursement%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPerforms and documents timely and accurate concurrent review of records and discusses plan of care with ED physicians to support the decision making process with regard to LOC decisions inpatient admission or outpatient observation services. (60%)%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E• Supports effective and timely communication of the physician decision regarding inpatient admission or outpatient observation services for accurate registration status, and delivery of appropriate notices to patient when required (ie IMM delivered by registration staff).%3C/span%3E%3Cbr%3E%3Cbr%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EConducts all CM activities with a focus on continuous quality improvement in a manner that is supportive of UHC quality initiatives and in compliance with applicable regulatory requirements.%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EAdditional Responsibilities%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPerforms other duties as assigned.%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EComplies with all policies and standards.%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EFor specific duties and responsibilities, refer to documentation provided by the department during orientation.%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EMust abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.%3C/span%3E%3C/li%3E%3C/ul%3E
%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EEducation%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EGraduate of an accredited school of Nursing (Required)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EBachelor%27s Degree (Preferred)%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EWork Experience%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E3+ years of clinical experience (acute care) (Required) %26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E1+ years of experience in utilization management/case management in an acute care setting (Required)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EExperience as an ED nurse (Preferred) %26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EExperience in ED utilization management/case management (Preferred) %26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EExperience with Interqual or Milliman criteria (Preferred)%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EKnowledge, Skills, %26amp; Abilities%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EMust have sound clinical knowledge base of the population to be served (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EKnowledge of Medicare, Medicaid and commercial payer regulations. (Preferred proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDetail-oriented and organized, with good analytical and problem solving ability. (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ENotable client service, communication, presentation and relationship building skills. (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAbility to function independently and as a team player in a fast-paced environment. (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EMust have strong written and verbal communication skills. (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDemonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.). (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDemonstrated ability to apply concepts, utilize sound judgment and work independently within a framework of guidelines. (Required proficiency)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECM software proficient. (Preferred proficiency)%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3ELicenses and Certifications%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ERegistered Nurse (RN), Ohio and/or Multi State Compact License Upon Hire (Required)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECM certificate (Preferred)%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EPhysical Demands%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EStanding Occasionally%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWalking Occasionally%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ESitting Constantly%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ELifting Rarely 20 lbs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECarrying Rarely 20 lbs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPushing Rarely 20 lbs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPulling Rarely 20 lbs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EClimbing Rarely 20 lbs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EBalancing Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EStooping Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EKneeling Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECrouching Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECrawling Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EReaching Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EHandling Occasionally%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EGrasping Occasionally%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EFeeling Rarely%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ETalking Constantly%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EHearing Constantly%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ERepetitive Motions Frequently%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EEye/Hand/Foot Coordination Frequently%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3ETravel Requirements%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E10%%3C/span%3E%3C/li%3E%3C/ul%3E
This page is fully interactive when JavaScript is enabled. Please enable JavaScript to apply or browse related roles.