Utilization Review Nurse – Weekends
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Job Description
Utilization Review RN managing evidence-based admission, stay, and discharge reviews at UAMS academic medical center. Coordinating payer communication and interdisciplinary discharge planning.
Responsibilities:
- Utilize pre-established, evidence-based screening criteria to validate the appropriateness of patient admissions
- Provide initial, continued-stay, and discharge screenings
- Monitor observation status continuously
- Communicate relevant information to payer carriers regarding patient stays
- Initiate referrals to internal and external interdisciplinary teams
- Establish a working diagnosis for every patient at initial review
- Communicate target length of stay and estimated discharge
- Coordinate discharge planning with the interdisciplinary team
- Document team, physician, and payer communications and care-coordination concerns
- Communicate with physicians regarding level of care or admission status
- Escalate appropriate cases to the Physician Advisor for secondary review
- Escalate payer denial and appeal issues to the Physician Advisor, CMO, or attending
- Perform other duties as assigned
Requirements:
- Associate’s Degree in Nursing (ADN)
- 5 years of clinical nursing experience
- Valid AR Registered Nursing license
- Certified Case Manager (CCM) or American Case Management (ACM) certification preferred
- Proof of legal authority to work in the United States on the first day of employment
- Annual TB Screening
- Criminal Background Check
- Substance Abuse Testing
Benefits:
- Medical, Dental and Vision plans available for qualifying staff and family
- Holiday, Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50,000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy
- Bonus Programs
- Hotel Lodging
- New Graduate RN Residency
- Support for Clinical Ladder
- National Certification
- Shared Governance
- Recognition Programs
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