RN UTILIZATION REVIEW

Froedtert • Menomonee Falls, WI

7d • $34 - $53 • Remote

About The Position

Assumes responsibility for assessing a patient's clinical status on admission and daily to determine the appropriate admission status type and level of care. Refers cases to the physician advisor, PA moonlighter, for a second level review as needed. Facilitates communication with service based multidisciplinary team as it relates to the patient and identified treatment plan. Works in accordance with established policies and procedures to ensure optimal patient outcomes. Has the ability to work with variable service lines and with multiple care teams.

Requirements

• Current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact).
• Minimum of 3 years of acute care nursing experience.
• Prior utilization management or case management experience.
• MCG certification within 18 months of hire.
• Professional knowledge of nursing theory and practice at a level normally acquired through completion of a program at an accredited School of Nursing.

Nice To Haves

• A minimum of 5 years of acute care nursing experience.
• Utilization of Interqual, MCG care web QI or Indicia evidence based guidelines.
• Knowledge of Medicare inpatient only surgical list, Medicare guidelines for admission, working DRG, and some familiarity with hospital coding.
• Bachelor's Degree in Nursing.
• Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification.

Responsibilities

• Assessing a patient's clinical status on admission and daily to determine the appropriate admission status type and level of care.
• Referring cases to the physician advisor, PA moonlighter, for a second level review as needed.
• Facilitating communication with service based multidisciplinary team as it relates to the patient and identified treatment plan.
• Working in accordance to established policies and procedures to ensure optimal patient outcomes.
• Working with variable service lines and with multiple care teams.

Benefits

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan - 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: Associate degree