Utilization Review LVN (on site) - Mental Health 194

Telecare • Santa Cruz, CA

120d • $43 - $53

About The Position

The Utilization Review (UR) Nurse works collaboratively with the treatment team to ensure that the care provided is appropriate and medically necessary. The UR Nurse also ensures that medical record documentation explains the care provided as well as the members served responses to treatment.

Requirements

• Graduation from accredited LVN program
• Two (2) years of acute inpatient psychiatric nursing experience
• Current LVN State license
• Current BLS certification
• Must be at least 18 years of age
• Must be CPR, Crisis Prevention Institute (CPI), and First Aid certified on date of employment or within 60 days of employment and maintain current certification throughout employment
• All opportunities at Telecare are contingent upon successful completion and receipt of acceptable results of the applicable post-offer physical examination, 2-step PPD test for tuberculosis, acceptable criminal background clearances, excluded party sanctions, and degree or license verification
• If the position requires driving, valid driver's license, a motor vehicle clearance and proof of auto insurance is required at time of employment and must be maintained throughout employment

Nice To Haves

• Utilization Review Nurse experience preferred

Responsibilities

• Demonstrates the Telecare mission, purpose, values, and beliefs in everyday language and contact with the internal and external stakeholders
• Reviews members served admission data and clinical documentation to ensure compliance with county and state regulations relating to medical necessity and case documentation
• When appropriate, interviews members served significant others and consults with existing outpatient team
• Consults with psychiatrist and medical staff regarding the members served diagnosis, medical justification, length of treatment, and case documentation
• Assesses records for appropriate level of care and treatment, aftercare, and discharge planning for members served
• Presents any treatment plan disagreements to the treatment team
• Advocates for required members served treatment with medical providers
• Provides training and information about utilization requirements to clinical, supervisory, and management staff
• Participates with departmental staff in utilization and quality improvement meetings and projects
• Prepares memorandum, letters, and correspondence and comprehensive daily members served status summaries
• Participates in Quality Assurance (QA) survey audit of the program to ensure agency compliance on utilization review regulations
• If employed at inpatient program, must assist with restraint of members served in the event of assaultive behavior and pass assault crisis/crisis prevention training
• If employed at outpatient program, must evade members served in the event of assaultive behavior and pass assault crisis/crisis prevention training

Benefits

• Expected starting wage range is $43.04 - $53.15
• Telecare applies geographic differentials to its pay ranges
• Starting pay is commensurate with relevant experience above the minimum requirements

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: Associate degree