RN - Registered Nurse (Remote, Casual) - Utilization Management

Essentia Health•Fargo, ND

22h•Remote

About The Position

Seeking a Registered Nurse to serve Essentia Health on a casual, as-needed basis in our Utilization Management department. This job is fully remote. To qualify for this position, an RN must have a minimum of one year of acute care experience. There is no on call, but some weekends and holidays are required. Residents of Alaska, California, Hawaii, Massachusetts, New York, New Jersey, Washington and Oregon are ineligible to apply. About Essentia Health: We are a top-rated employer offering work-life balance, long term career stability, opportunities for growth, and work you can be passionate about! Our mission guides us every day: We are called to make a healthy difference in people’s lives. This calling resonates deeply for our caregivers and our colleagues working behind the scenes, who all bring high-quality, compassionate care to the patients we are privileged to serve. We are like nowhere else: https://vimeo.com/284233541 What You'll Do: Performs day-to-day activities involved in the utilization management process and assists in the promotion and maintenance of high quality and continuity of care in a cost-effective manner. This position requires high level of customer service skills to establish and enhance positive relationships with patients, co-workers, physicians and others. Collaborates with the related providers to ensure appropriate quality of care and utilization of designated patient services. Provides management of care delivery to patients and families of all ages. This includes assessing, planning, and coordination of services to meet an individual’s health needs in a cost-effective manner. Will also be responsible for discharge planning and reviewing the medical necessity and utilization of services that are required. Employees scheduled 24+ hours weekly enjoy these benefits: Health Insurance and HSA or FSA accounts Dental and Vision insurances Supplemental insurances- critical illness, accident, & hospital indemnity Paid short-term disability, long-term disability, and basic life insurance Supplemental Life and Accidental Death & Dismemberment insurance Tuition Reimbursement PTO accrual and 7 paid holidays per year Paid parental leave after one year Adoption assistance after one year Bereavement & Jury Duty (all regularly scheduled employees) All employees, including casual, enjoy these benefits: Take Charge (employee wellness program) Guidance Resources (free confidential counseling) Employee discount program 401(k) retirement account (traditional & Roth) 401(k) matching & discretionary contributions (subject to service requirements) Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000. To search for more jobs, please CLICK HERE. Find more than a job. Find more in yourself. Find your calling. Essentia Health seeks employees who embrace our commitment to patient- and family-centered care in communities both large and small. We're looking for people who are committed to making patients and their families feel known and understood. People who understand what it means to be Here with you. People who are willing to use their strengths to help others. Our Values Quality | Hospitality | Respect | Joy | Justice | Stewardship | Teamwork Essentia Health is an Equal Opportunity/Affirmative Action Employer. Essentia Health does not discriminate in employment because of age, color, creed, culture, disability (physical or mental), ethnicity, familial status, gender identity or expression, genetic information, language, local Human Rights Commission activity, national origin, military service, race, religion, sex, sexual orientation, socioeconomic status, or public assistance status. Job offers are contingent upon successful completion of post-offer screenings. Screenings includes verification of your legal right to work in the United States, a health screening and immunization review, verification of applicable licensure, certifications, education, and experience, and background checks including criminal, urine drug screen and MVR where required.

Requirements

Minimum of one year work experience in an acute care setting is required.
Current licensure as a Registered Nurse.
BSN or ADN degree from an accredited school or college of nursing.

Responsibilities

performing utilization review functions and acting as liaison to third party payers
performing documentation and review to support medically unnecessary day (MUD) database
participating in collaborative practice teams
collaborating with physicians, providers and payers to resolve issues and problems
investigating information for appeals on denied cases as assigned
serving as a resource to physicians and ancillary staff to help determine appropriate admission status
Collaborates with the related providers to ensure appropriate quality of care and utilization of designated patient services.
Provides management of care delivery to patients and families of all ages.
This includes assessing, planning, and coordination of services to meet an individual’s health needs in a cost-effective manner.
Will also be responsible for discharge planning and reviewing the medical necessity and utilization of services that are required.