Registered Nurse - Mid Shift ED UM RN - 12 Hour Days

Cedars-Sinai • Los Angeles, CA

7h • Onsite

About The Position

This dynamic opportunity is available with Cedars-Sinai, a world-class facility recognized as one of the top ten in the United States and one of the best places to work in Southern California. The organization has achieved its fifth consecutive Magnet designation for nursing excellence and has been named one of America’s Best Hospitals by U.S. News & World Report. The role requires expert clinical skills, a passion for the highest quality, and dedication to patient happiness, where every effort, detail, and second has a crucial impact on the lives of others.

Responsibilities

• Validate patients' placement to be at the most appropriate level of care based on nationally accepted admission criteria
• Use medical necessity screening tools, such as InterQual or MCG criteria, to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures and an estimation of the patient's expected length of stay
• Secure authorization for clinical services through timely collaboration and communication with payers as required
• Follow the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review
• Collaborate with Care Coordinators to identify and follow up on Observation class patients
• Follow up with the payer to verify approval/authorization of the hospital stay (all dates of services)
• Function as an advocate, and contact person for the care team, patient/family when communicating with payers, and or outside agencies to ensure continuity of care, optimal clinical resource outcomes, and appropriate financial management for the patient and the organization

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees