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Providence Health & Services Care Management RN - Utilization Review in Centralia, Washington

Description:

Providence is calling a RN Case Manager 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.

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.

Qualifications:

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).

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: On Call

Shift: Variable

Job Category: Case Management

Location: Washington-Centralia

Req ID: 233643

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