ED Utilization Management RN

About the role

Monitors alerts for ED registration through the facility EMR. Evaluates cases for target conditions and provides support and discharge planning consultations to ED staff. Coordinates post-ED care and communication with primary care practices.

Responsibilities

• Performs real-time clinical reviews for appropriate next site of care using the facility EMR
• Contacts and follows up with the respective ED clinicians as needed
• Provides ongoing updates depending on the patient's condition
• Updates case status in the EMR system
• Maintains open communications and builds collaborative relationships with ED providers, ED staff, and primary care providers
• Ensures patients are properly identified at the point of service throughout the care continuum
• Assists ED staff with understanding and utilization of benefits enhancement
• Other duties as assigned

Qualifications

• Associate's of Nursing [Required]
• Bachelor's of Nursing [Preferred]
• Registered Nurse (RN) [Required]
• Certified Case Manager (CCM) [Preferred]
• Accredited Case Manager (ACM) [Preferred]
• Basic Life Support (BLS) [Preferred]

Experience

• 1+ Utilization Management or Care Management experience [Preferred]
• 3+ acute care and/or emergency department experience [Required]
• 3+ years related experience [Required]

Skills

• Knowledge and understanding of utilization management criteria [Required]
• Excellent analysis, problem-solving and critical thinking skills [Required]
• Ability to use data to measure progress and achieve outcomes [Required]
• Strong business communication skills to resolve issues and communicate with internal and external parties [Required]
• Ability to work with little supervision [Required]
• Self-motivated [Required]
• Microsoft office suite of applications experience [Required]
• Excellent time management skills to effectively navigate in fast-paced work environment with time constraints in place [Required]
• Ability to interact effectively with providers and other health care professionals [Required]
• Strong clinical skills to evaluate severity of disease state [Required]
• Discharge planning knowledge [Required]

Benefits

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Pay

$32.76 - $57.47

Schedule

Full time, Shift Night (United States of America)