RN Utilization Manager - (Per Diem) Care Management

We need to output HTML fragment with sections for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title. Must not include Job ID etc. Must preserve all substantive info. Remove boilerplate (EEO, accommodations, etc). Must not include placeholder text like "commensurate with experience". Must not create Pay/Schedule/Benefits unless posting actually states them. The posting includes Salary Range: $35.87 - $51.57 per hour (Hiring Range). Also Work Schedule: Day. Also Work Type: Per Diem, Standard Hours Per Week: 4.00. So we have Pay and Schedule info. Benefits? Not mentioned. So we should not create Benefits section. Also we have Education Requirements, Licensure/Certification Requirements, Professional Experience Requirements, Knowledge/Skills/and Abilities Requirements. Those could go under Requirements or Qualifications. The instruction: Use headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide which sections to include based on content. We have a summary description (first paragraph) that could be About the role. Then Responsibilities section with bullet list. Then Requirements/Education/Licensure/Experience could be under Requirements or Qualifications. Knowledge/Skills/and Abilities could be under Skills. Pay and Schedule sections. We must not repeat job title. Must not include metadata like Legal Employer, Entity, Organization Unit, Work Type, Standard Hours Per Week (but Standard Hours is schedule info, we can include in Schedule). Work Assignment Type: Onsite (maybe schedule? but not needed). Work Schedule: Day. Exempt From Overtime: Exempt: Yes (maybe schedule? but could be included). We'll include schedule info: Work Type: Per Diem, Standard Hours Per Week: 4.00, Work Schedule: Day, Exempt: Yes. Pay: Salary Range: $35.87 - $51.57 per hour (Hiring Range). Pay offers determined by experience and internal equity. We must not include boilerplate like EEO statement, accommodations, etc. We must preserve all substantive information. So we need to include all responsibilities bullet points, all requirements bullet points, etc. Let's extract content. From description: "Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina." That's introductory fluff but substantive? It's about the organization. Could be part of About the role. "Summary Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing type, and medical necessity. This may include delivering notifications to patients directly. Interface is completed verbally, via email, data base tasks, or other electronic communication and via telephone." That's summary; could be part of About the role. Then "Responsibilities" heading with bullet list: - Clinical Review Process - Uses approved criteria and conducts admission review/status change review within 24 hours of patient admission to the hospital to ensure appropriateness of the setting and timely implementation of the plan of care. - Identifies and obtains observation status as appropriate. - Partners with physicians, nursing, and other care providers to help ensure timely and accurate documentation of patient data and treatments. - Communicates daily with the Case Manager to manage level of care transitions & appropriate utilization of services. - Coordinates with the support center to assure third party payor pre-certification and/or re-certifications when required. - Utilizes high risk screening criteria to make appropriate referrals to Manager. - Discharge Facilitation - Identifies patient/families with the complex psychosocial, on-going medical discharge planning issues, continuing care needs by initiating appropriate case management referrals. - Initiates appropriate social work referrals. - Utilization Management Process - Performs utilization management assessments and interventions, using collaboration with interdisciplinary team approach, on assigned patients as appropriate to ensure optimal patient outcomes. - Using approved criteria, conducts continued stay and quality reviews to monitor the patient's progress along the continuum of care and intervenes as necessary to ensure appropriateness of setting and that the services provided are quality-driven, efficient, and effective. - Enters all pertinent review data into the correct computer system in a timely manner. - Consults with Physician Advisor as necessary to resolve barriers through appropriate administrative and medical channels. - Utilization Outcomes Management - Monitors and guides to trend interdisciplinary documentation and guides medical staff in documentation that will assist in coding accuracy, enhance quality of care, reflect accurate severity of illness and appropriate reimbursement. - Facilitates patient movement to appropriate (acuity) level of care including observation status issues through collaboration with patient/family, multidisciplinary team, third party payors and resource center. - Provides information regarding denials and approvals to designated entities. - Assists in coordination of practice parameter development with the assigned departments/sections/specialties of Medical Staff. - Oversees collection and analysis of patient care and financial data relevant to the target case types. - Directs delivery of notifications to patients (includes traveling to hospital(s) to deliver notifications. Then "Other Information" includes: Education Requirements Graduation from a state-accredited school of professional nursingIf hired after October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a Bachelor's degree with a major in Nursing or a Master's degree with a major in Nursing within seven years of employment date. Licensure/Certification Requirements Licensed to practice as a Registered Nurse in the state of North Carolina. Professional Experience Requirements Two (2) years of clinical experience in a medical facility and/or comparable Utilization Management experience. Knowledge/Skills/and Abilities Requirements (no specifics listed? Actually after that heading there is no list; maybe missing. The text shows "Knowledge/Skills/and Abilities Requirements" then immediately "Job Details". So there is no content; we should not create a Skills section if no specific content. But we could still include if there is any implied? The instruction: never emit a heading followed by filler/placeholder text. So we should not create Skills section if no content. Then Job Details: Legal Employer: NCHEALTH Entity: Johnston Health Organization Unit: Care Management - Work Type: Per Diem Standard Hours Per Week: 4.00 Salary Range: $35.87 - $51.57 per hour (Hiring Range) Pay offers are determined by experience and internal equity Work Assignment Type: Onsite Work Schedule: Day Job Location of Job: US:NC:Smithfield Exempt From Overtime: Exempt: Yes This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position. We need to preserve substantive info: Work Type, Standard Hours, Pay, Work Schedule, Location, Exempt status. Also maybe mention Onsite. We should not include Legal Employer, Entity, Organization Unit as headings; we can fold into a short paragraph maybe under About the role or a separate "Details" but we only allowed specific headings. We could include them in a paragraph under About the role or maybe under a generic "About the role" we can incorporate location and work type. But we must not invent headings. We can include a

with that info. We must not include boilerplate like EEO statement etc. The text after "This position is employed..." includes a statement about equal opportunity etc. Actually after that we have: "Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity." That's boilerplate; we must remove. Thus final HTML: sections: About the role (maybe combine summary and intro), Responsibilities (ul), Requirements (maybe combine Education, Licensure, Experience), Pay, Schedule. We need to decide if we need Qualifications separate from Requirements. The posting has Education, Licensure, Experience; those could be Requirements. Qualifications maybe not distinct. We could omit Qualifications if no distinct content. Skills we omit because no content. Thus sections: About the role, Responsibilities, Requirements, Pay, Schedule. Check if any content for Benefits: none, so omit. Now craft HTML. We'll need to preserve all substantive info from responsibilities list exactly. Let's list responsibilities bullet points as

items. We need to ensure we don't lose any bullet. From responsibilities: - Clinical Review Process - Uses approved criteria and conducts admission review/status change review within 24 hours of patient admission to the hospital to ensure appropriateness of the setting and timely implementation of the plan of care. - Identifies and obtains observation status as appropriate. - Partners with physicians, nursing, and other care providers to help ensure timely and accurate documentation of patient data and treatments. - Communicates daily with the Case Manager to manage level of care transitions & appropriate utilization of services. - Coordinates with the support center to assure third party payor pre-certification and/or re-certifications when required. - Utilizes high risk screening criteria to make appropriate referrals to Manager. - Discharge Facilitation - Identifies patient/families with the complex psychosocial, on-going medical discharge planning issues, continuing care needs by initiating appropriate case management referrals. - Initiates appropriate social work referrals. - Utilization Management Process - Performs utilization management assessments and interventions, using collaboration with interdisciplinary team approach, on assigned patients as appropriate to ensure optimal patient outcomes. - Using approved criteria, conducts continued stay and quality reviews to monitor the patient's progress along the continuum of care and intervenes as necessary to ensure appropriateness of setting and that the services provided are quality-driven, efficient, and effective. - Enters all pertinent review data into the correct computer system in a timely manner. - Consults with Physician Advisor as necessary to resolve barriers through appropriate administrative and medical channels. - Utilization Outcomes Management - Monitors and guides to trend interdisciplinary documentation and guides medical staff in documentation that will assist in coding accuracy, enhance quality of care, reflect accurate severity of illness and appropriate reimbursement. - Facilitates patient movement to appropriate (acuity) level of care including observation status issues through collaboration with patient/family, multidisciplinary team, third party payors and resource center. - Provides information regarding denials and approvals to designated entities. - Assists in coordination of practice parameter development with the assigned departments/sections/specialties of Medical Staff. - Oversees collection and analysis of patient care and financial data relevant to the target case types. - Directs delivery of notifications to patients (includes traveling to hospital(s) to deliver notifications. Check for any missing bullet: after "Utilization Outcomes Management" there is a bullet "Monitors and guides to trend interdisciplinary documentation and guides medical staff in documentation that will assist in coding accuracy, enhance quality of care, reflect accurate severity of illness and appropriate reimbursement." Good. Now Requirements: Education, Licensure, Professional Experience. Education: "Graduation from a state-accredited school of professional nursingIf hired after October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a Bachelor's degree with a major in Nursing or a Master's degree with a major in Nursing within seven years of employment date." Note there is missing space after nursing;