Registered Nurse - Utilization Review Coord - Psychiatric Medical Unit
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Trinity Health
Grand Rapids, MI, US
Summary
The RN Intake Coordinator performs utilization reviews to ensure medical necessity and proper reimbursement for acute care hospitalizations. They collaborate with the healthcare team to evaluate levels of care and facilitate effective discharge planning.
Job Description
Employment Type:
Full time
Shift:
Night Shift
Description:
Position Summary:
Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to payors
ensuring proper reimbursement for care. In collaboration with members of the health care team, conducts
observation, admission, concurrent, discharge and retrospective reviews to evaluate the appropriate level of care,
continued stay, and status of discharge planning.
What you will work:
- Full time
- 40 hours per week
- 11:00 PM - 7:30 AM
- Remote
What you will do:
- Perform all aspects of utilization review to ensure the medical necessity of acute care hospitalization has the existence of supportive documentation in the EMR
- Provide all external review organizations the information necessary to complete reviews and effect maximum financial reimbursement
- Collaborate with Case Management
- Provides consultation and information to physicians, case managers and other members of the health care team
What you will need:
- Bachelor of Science in Nursing (BSN)
- Current State of Michigan Registered Nurse License
- Three years acute care as a RN
- Preferred: Two years recent acute care utilization management experience, experience in facility audits/appears and processes
- Ability to work autonomously with little direction and be accountable for outcomes
What you will work:
- Full time
- 40 hours per week
- Night shift
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
With more than 11,000 employees in more than 185 locations, St. Peter’s Health Partners is the Capital Region’s largest and most comprehensive not-for-profit integrated health care network, which provides high-quality, compassionate, and sophisticated care to thousands of people every day. St. Peter’s Health Partners is a member of Trinity Health. For more information, please visit www.SPHP.com.
Founded
2011
Company size
10,001+ employees
Industry
Healthcare
Org type
Nonprofit
Headquarters
Albany, NY
With more than 11,000 employees in more than 185 locations, St. Peter’s Health Partners is the Capital Region’s largest and most comprehensive not-for-profit integrated health care network, which provides high-quality, compassionate, and sophisticated care to thousands of people every day. St. Peter’s Health Partners is a member of Trinity Health. For more information, please visit www.SPHP.com.
Founded
2011
Company size
10,001+ employees
Industry
Healthcare
Org type
Nonprofit
Headquarters
Albany, NY
