RN Coordinator - Utilization Review Acute Rehab Remote PRN Days

American Addiction Centers • Charlotte, NC

3d • $36 - $53 • Remote

About The Position

The PRN URC would not have a set schedule. The PRN URC would cover when teammates are out on PTO. This role identifies clinical, financial, and psychosocial needs of patients/families and provides leadership and guidance to the multidisciplinary team to develop an individualized plan of care. The coordinator ensures essential information and necessary forms are placed in the revenue cycle tool and available for the revenue cycle team and other disciplines. They also provide necessary documentation and information to third-party administrators as needed, perform admission and concurrent reviews, and apply clinical guidelines during these reviews. The role identifies potential third-party denials and works with the multidisciplinary team to identify and implement alternative plans of care. Additionally, the coordinator initiates and requests authorizations for post-acute care as needed to facilitate care coordination, refers pertinent cases to the Medical Director, Service Director, and/or Physician Advisor, and collaborates with the physician to plan and implement medical and multidisciplinary plans of care. They identify and escalate barriers and problems to the multidisciplinary team and leadership for intervention and resolution, and develop and maintain accurate case records of assigned cases, documenting in the patient's medical record according to department and facility standards.

Requirements

• Graduation from an accredited School of Nursing required.
• applicable state RN licensure required.
• Basic Life Support (BLS) for Healthcare Provider (HCP) per facility requirements

Nice To Haves

• Bachelor's degree in nursing preferred.
• Related experience preferred

Responsibilities

• Identifies clinical, financial, and psychosocial needs of patients/families and provides leadership and guidance to the multidisciplinary team to develop an individualized plan of care.
• Ensures essential information and necessary forms are placed in the revenue cycle tool and available for the revenue cycle team and other disciplines.
• Provides necessary documentation and information to third party administrators as needed.
• Performs admission and concurrent reviews.
• Applies clinical guidelines during Admission and Concurrent reviews and identifies potential third-party denials. Works with multidisciplinary team to identify and implement alternative plans of care.
• Initiates and request authorizations for post-acute care as needed to facilitate care coordination.
• Refers pertinent cases to the Medical Director, Service Director, and/or Physician Advisor in a timely manner.
• Collaborates as needed with the physician to plan and implement medical and multidisciplinary plan(s) of care, utilizing clinical pathways when appropriate and available.
• Identify and escalate barriers and problems to the multidisciplinary team and leadership for intervention and resolution.
• Develops and maintains accurate case records of assigned cases. Documents in the patient's medical record according to department and facility standards.

Benefits

• Paid Time Off programs
• medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level