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Case Manager Utilization Review Nurse - Full Time

Company: Sunrise Hospital and Medical Center
Location: Las Vegas
Posted on: April 17, 2018

Job Description:

Serving the community for nearly 60 years, Sunrise Hospital and Medical Centerprovides the most comprehensive, quality healthcare in Southern Nevada. As LasVegas' largest acute care facility, Sunrise provides sophisticated inpatientand outpatient services to the community. Sunrise Hospital and Medical Center has been selected the Consumer Choice Awardrecipient for 15 consecutive years and had earned the American StrokeAssociation's Get With The Guidelines (GWTG) Gold Plus Performance AchievementAward. We are also ranked Nursing Professionals Top 100 Hospitals to workfor! POSITION SUMMARY: Case Manager/Utilization Review Nurse - Full Time Days The RN Case Manager/UtilizationReview Nurse is responsible for assessing discharge-planning needs for the patientsto coordinate the delivery of healthcare services in conjunction with nursing,physicians, ancillary hospital departments, patients and families, and toidentify and coordinate post-hospital needs of all patients, infant throughgeriatrics, in order to promote quality, continuity of care and safety for thepatient. This position will facilitate to meet those needs, to facilitate timelyand appropriate discharges from the hospital, and to identify opportunities forimprovements in patient care. The RN Case Manager/Utilization Review Nurse willfacilitate Care Coordination through the IDT (Interdisciplinary Team) rounds.The RN Case Manager/Utilization Review Nurse will act as a patient advocate,investigate all adverse occurrences, perform staff education related toutilization of resources, discharge planning, and psychosocial aspects ofhealthcare delivery. In addition, the RNCase Manager/Utilization Review Nurse must provide documentation of allfunctions as required by regulatory agencies. He/she will monitor utilizationof resources, track any avoidable days identified, provide clinical reviews in atimely manner utilizing InterQual criteria, and follow review protocols for thedepartment. The RN Case Manager/Utilization Review Nurse would determine themedical necessity for all admissions and need for continued stay, as well as beable to status the patient in the correct level of care --- Observation VS.Admission. 102-Case Manager Utilization Review - Full Time No Weekends EDUCATION: Graduateof an accredited nursing program --- diploma, associate degree, or baccalaureate program; BSNpreferred. EXPERIENCE: Minimum of three (3)years of clinical experience in nursing; Minimum of one (1) years in acute hospital case management andutilization review for Medicare, Managed Care and Commercial payors. Must have knowledge of Interqual.Must have demonstrated prior job interactivity with multiple departments, disciplines andphysicians, as well as organizational levels. Must have knowledge of DRGs and GMLOS. CERTIFICATION: Case Management Certification (CCM) or CPUR(Certified Professional Utilization Review) preferred; BLS required. LICENSURE: Current license topractice as an RN in Nevada. Independently maintains license. Maintains required continuing educationunits to practice and maintain license.

Keywords: Sunrise Hospital and Medical Center, Las Vegas, Case Manager Utilization Review Nurse - Full Time, Healthcare, Las Vegas, Nevada

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