Care Management RN - Utilization Review

Providence Health & Services Centralia , WA 98531

Posted 1 week ago

Providence is calling a RN Case Manager (Per Diem, Day Shift) to work in Utilization Review at Providence Centralia Hospital in Centralia, WA.

We are seeking a compassionate and caring RN to ensure that patients and their families receive quality, cost-effective health care. This role will have a weekend rotation.

In this position you will:

  • Assess and monitor patients, determine eligibility for treatments and ensure the plan of care meets the patient's needs

  • Work as a catalyst to promote coordination of care, continuity of care in the achievement of consistent and/or expected clinical conditions and is a patient advocate in utilization of efficient resource management.

  • Coordinate care for complex patients from pre-admission to immediate post-discharge.

  • Participate in facilitating coordination and communication between all members of the health care team, in the decision making process to minimize fragmentation of the care delivery system and prevent hospital readmissions.

  • Assist the health system in assuring financial viability by performing comprehensive medical reviews utilizing appropriateness criteria and interpreting implication of clinical status / medical treatment plans with current federal regulations guidelines; thereby facilitating accurate and timely billing process and payment, consistent with regulatory requirements.

Required qualifications for this position include:

  • Associate's Degree in Nursing.

  • Current Registered Nurse (RN) licensure in Washington State.

  • Three years in medical/surgical (or comparable acute care) nursing experience.

Preferred qualifications for this position include:

  • Bachelor of Science Degree in Nursing (BSN).

  • One year recent acute care experience.

  • Quality and or utilization review and or case management experience.

  • Microsoft Office (Word and Excel) experience.

About the hospital you will serve:

Providence Centralia Hospital in Centralia, Washington is a 127-bed, not-for-profit hospital providing emergency, diagnostic, cancer, birthing and surgical services. It consistently receives high scores on accreditation surveys by the Joint Commission, the Washington Department of Health (DOH) and the Washington Department of Social and Health Services (DSHS).

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Care Management RN - Utilization Review

Providence Health & Services