RN Utilization Manager (PRN)

St. Tammany Parish Hospital•Covington, LA

About The Position

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. JOB DESCRIPTION AND POSITION REQUIREMENTS Scheduled Weekly Hours: TBD Work Shift: 0800-1700 (flexible) Summary of the Job: The Utilization Manager is responsible to assist in the development, planning, coordination, and administration of the activities of Utilization Management. Job responsibilities include but are not limited to the following: daily review of medical records to determine appropriateness and medical necessity of admission, continued stay, use of resources, and discharge readiness. Assumes responsibilities delegated by the Department Head. Minimum Qualifications: Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing. Five years of hospital nursing experience preferred. Experience in the field of Utilization Management activities highly preferred. Basic understanding of CPT-ICD-9 coding principles and DRG management preferred. Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing. Ability to demonstrate effective written and verbal communication skills and possess emotional and professional maturity. Highly organized and efficient in establishing priorities and performing tasks within specific timeframes. Self-motivator requiring minimal supervision. Views problems as a challenge and investigates alternatives which demand creativity, flexibility and the ability to work under stress. Responsible for maintaining strict confidentiality of all verbal & written information and documents. Knowledgeable in the Utilization Management review process. Physical Demands: Must possess good physical health. Some requirements include but are not limited to standing, sitting or walking for long periods of time. Lifting at least 10 pounds is required. Physical Effort required: Constant (67%-100%) – seeing Frequently (34%-66%) - handling/feeling, talking, hearing Occasionally (1%-33%) – lifting, carrying, pushing/pulling, stooping, crouching, reaching Contact Information: Jennifer Saint, HR Talent Partner Talent Acquisition - Human Resources EMPLOYMENT Each St. Tammany Health System staff member is expected to conduct himself or herself according to our mission, vision and values. Please take time to review those expectations, which can be found by clicking here, before applying for employment. If you feel you are unable to demonstrate those characteristics, we respectfully request that you do not proceed with the application process. EQUAL OPPORTUNITY EMPLOYER St. Tammany Health System is an Equal Opportunity Employer. St. Tammany Health System is committed to equal employment opportunity for all employees and applicants without regard to race, color, religion, sex, age, national origin or ancestry, citizenship, sexual orientation, gender identity, veteran status, disability status, genetic information or any other protected characteristic under applicable law. St. Tammany Health System is a full-service acute care facility that delivers today’s life-improving procedures with the latest technology, highest quality and the utmost care to area residents. From wellness and prevention to diagnosis, treatment, rehabilitation and recovery, the St. Tammany Health System delivers the very latest technology, the most accomplished specialists and highly personalized, caring staff to ensure patients and their families receive world-class healthcare close to home. St. Tammany Health System is an independent service district in a clinically integrated partnership with Ochsner Health System. Together, the two organizations focus on aligning their healthcare offerings to best serve patients and families in west St. Tammany Parish and surrounding areas.

Requirements

Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing
Five years of hospital nursing experience preferred
Experience in the field of Utilization Management activities highly preferred
Basic understanding of CPT-ICD-9 coding principles and DRG management preferred
Graduate of accredited school of Nursing and maintains current R.N. licensure by the Louisiana State Board of Nursing
Ability to demonstrate effective written and verbal communication skills and possess emotional and professional maturity
Highly organized and efficient in establishing priorities and performing tasks within specific timeframes
Self-motivator requiring minimal supervision
Views problems as a challenge and investigates alternatives which demand creativity, flexibility and the ability to work under stress
Responsible for maintaining strict confidentiality of all verbal & written information and documents
Knowledgeable in the Utilization Management review process
Must possess good physical health
Some requirements include but are not limited to standing, sitting or walking for long periods of time
Lifting at least 10 pounds is required

Nice To Haves

Five years of hospital nursing experience preferred.
Experience in the field of Utilization Management activities highly preferred.
Basic understanding of CPT-ICD-9 coding principles and DRG management preferred.

Responsibilities

daily review of medical records to determine appropriateness and medical necessity of admission, continued stay, use of resources, and discharge readiness
Assumes responsibilities delegated by the Department Head

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