利用审查护士 - 利用管理全职
Utilization Review RN - Utilization Management FT
Utilization Review RN - 远程办公。该职位为全职，工作时间为8小时，白班。
为我们的南加州教区提供前瞻性、回顾性和同时的利用审查。根据健康计划的要求，对所有付款人进行入院期间的临床审查和医疗记录审查。该职位需要具备扎实的临床背景，以及在利用管理、医疗必要性和患者状态评估方面的专业知识和技能。利用管理护士必须能够在快节奏、快速变化的监管环境中高效地处理多样化的任务，展现出优秀的谈判、沟通、解决问题和决策能力。
普罗维登斯的护理人员不仅仅是被重视——他们至关重要。加入普罗维登斯加利福尼亚地区服务团队，在以患者为中心、关注整体健康的文化中茁壮成长，这种文化建立在理解、承诺和相互尊重的基础上。你的声音在这里很重要，因为我们知道，要激励和留住最优秀的人才，必须赋予他们力量。
所需资格：
- 护理学副学士学位。
- 入职时需持有加利福尼亚注册护士执照。
- 两年在远程UR环境工作的经验，或在急性医院担任病例管理员的经验。
优选资格：
- 护理学学士学位。
- 护理学硕士学位。
- 具有使用Interqual指南的经验。
- 在多医院和/或整合医疗系统中的工作经验。
为什么加入普罗维登斯？
我们的一流福利专为支持你和你的家庭保持健康、专业成长和实现财务安全而设计。我们照顾你，这样你就可以专注于实现我们关爱每个人，尤其是我们社区中最弱势群体的使命。
最初发布于喜马拉雅山
查看英文原文
Utilization Review RN - Remote. This position is Full-time and will work 8-hour, Day shifts.
Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
- Associate's Degree in Nursing.
- Upon hire: California Registered Nurse License.
- 2 years of experience working in a remote UR environment or working as an acute hospital case manager.
Preferred Qualifications:
- Bachelor's Degree in Nursing.
- Master's Degree in Nursing.
- Experience working with Interqual guidelines.
- Experience in a multi-hospital and/or integrated healthcare system.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Originally posted on Himalayas