Utilization Review Nurse

Overview

CHI St. Vincent a regional health network serving Arkansas is part of CommonSpirit Health. We have served Arkansas since 1888 with a history of many firsts. Together with more than 4500 coworkers 1000 medical staff and 500 volunteers we consistently receive praise for care advancements. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. CHI St. Vincent provides you with the same level of care you provide to others. We care about our employee well-being and offer benefits that complement and support your work/life balance.We offer the following benefits to support you and your family:Free Premium Membership to our Care@Work program to help employees with child care pet care senior caregivers housekeepers & more.Health/Dental/Vision Insurance Flexible spending accounts Voluntary Protection: Group Accident Critical Illness and Identity Theft Adoption Assistance Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Tuition Assistance for career growth and development Matching 401(k) and 457(b) Retirement Programs Wellness Programs.

Responsibilities

Analyzes insurance, governmental and accrediting agency standards to determine criteria concerning admissions, treatment and length of stay of patients.

Reviews medical records for appropriate level of care.

Compares inpatient medical records to established criteria and confers with medical and nursing personnel and other professional staff to determine appropriateness of treatment and length of stay.

Abstracts data from records and maintains statistics.

Monitors and tracts Medicare denials, works with medical records to review third party payor denials.

Works with other disciplines to develop a discharge plan appropriate for patients Identified needs.

Works closely with providers regarding patient status and appropriate level of care.

Rounds on patients, available to answer questions and help with discharge planning needs of patient.

Records all care information concisely, accurately and completely, in a timely manner, in the appropriate format and on the appropriate forms

Maintains order, stock, and cleanliness of all areas in the department

Practices safe work habits, compliance with safety rules and regulations, and adheres to safety policies

Utilizes resources appropriately and follows facility guidelines, policies, and procedures

Qualifications

Unencumbered license to practice in the State of Arkansas

4 years of acute care nursing experience required

BSN Required

Previous case management, utilization management, or discharge planning experience strongly preferred

Pay Range

$40.00/hour

We are an equal opportunity/affirmative action employer.