ER Utilization Management RN

Location
Rockville, MD
Posted
Aug 05, 2020
Closes
Oct 05, 2020
Ref
R-010445
Industry
Healthcare
Hours
Full Time
Seasoned RN to work in the Emergency Department. MCG/Interqual skill set. Submit clinical timely and accurately to Insurance companies.

Work Schedule:

Adventist HealthCare seeks to hire a Utilization Manager (RN) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing.

As the Utilization Manager, you will:
•Review medical records for clinical criteria, appropriate level of care and compliance with standards
•Assure compliance with standards; i.e. CAHO, COMAR, HIPAA, Federal and State Regulations
•Conduct pre-authorization as needed; performs concurrent and continued stay reviews.
•Prepare and submits medical record for appeal
•Assist the treatment team with information related to discharge planning and obtains authorization as needed
•Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients

Qualified candidates will possess:
•Bachelor's degree in nursing required, Master's preferred
. R.N.required
•College level reading, writing and math with strong verbal skills
•Basic PC skills (MS word, Excel and Access)
Requirements:
•Type 50WPM
•Time Management Efficient and accurate reviews
•CERNER knowledgeable a plus
•Interqual/MCG knowledge
•Knowledge of medication and medical terminology
•Strong customer service skills
•Able to handle a multi-task environment and work independently

At Adventist HealthCare our job is to care for you. We do this by offering:
• Work life balance through non-rotating shifts
• Recognition and rewards for professional expertise
• Free Employee parking
• Competitive comprehensive benefit plans offered (including health, disability, PTO and 403B retirement plan with matching and 3-year vesting)
• 100% Coverage for inpatient hospitalization and outpatient procedures - at Adventist HealthCare facilities
• 100% Coverage for urgent care nationwide - zero copay

If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference. Join the Adventist Healthcare team today! Apply now to be considered.

Tobacco Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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