Job Openings in Sacramento County and Beyond

Discharge Utilization Review Nurse -Direct Hire

Sacramento, CA | Direct Hire Position

Post Date: 06/27/2018 Job ID: 39630.1 Industry: Healthcare/Medical
We are recruiting for a motivated Utilization Review Nurse who possess strong critical thinking skills, and is ableto switch direction quickly. The UR nurse will need to have a strong intensive discharge planning background, as well as experience working with complex cases in both the inpatient and outpatient acute setting. The UR Nurse will be responsible for evaluating authorization requests and authorize, modify, or pend per appropriate criteria. The UR Nurse coordinates initial and ongoing assessments to ensure continuity of care through discharge. This is a direct hire opportunity.

Responsibilities: Manage continuous care from admission through discharge for assigned patients. Research and refer members to sources for alternative funding, community services and other services. Coordinate care between PCP and other physicians. Identify cases for possible peer reviewers to evaluate the appropriateness and necessity of care and or quality of care concerns. Assure referrals are complete and eligibility benefits verified, prior to authorizing inpatient and outpatient care. Authorize home health visits as needed; arrange for admissions to ancillary medical facilities. Authorize outpatient services requested, determine medical necessity; specialty services.

Requirements: Graduated from an accredited school of nursing required. Current and Valid California Registered Nurse or Licensed Vocational Nurse required. 2 years' professional nursing experience in an acute care setting or outpatient setting preferred or; 2 years utilization/case management experience in the managed care industry. Exceptional verbal and written communication skills. Excellent critical thinking and analytical skills. Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers/members. Ability to multi-task, exercise excellent time management, and meet multiple deadlines. High attention to detail and ability to document information accurately. Proficient with Microsoft Office.

Not ready to apply?

Send an email reminder to:

Share This Job:

Related Jobs: