Utilization Review Nurse
The posted compensation range of $32.75 - $43.24 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
As a Utilization Nurse Nurse with CHI St Vincent Infirmary, you’ll work with insurance, government and nursing personnel to determine appropriateness of treatment and length of stay.
You’ll build trust in these interactions by showing compassion, using your critical thinking skills, and remembering that each patient requires a custom care plan tailored to their needs. You will support patients by identifying and removing patient care barriers that will regress their healing. . It shines as you develop enhanced discharge plans yielding optimal outcomes for each patient.
CHI St Vincent Infirmary is a 600 bed faith-based, non-profit, acute care facility providing quality health care to patients and communities from all over the State of Arkansas. Our level II trauma center is a regional referral center for cardiology, trauma, behavioral health, cancer care, neurosciences, and other specialties. We have been consistently named by US News & World Report as one of the State’s best hospitals, with high performance in heart care, colorectal surgery, and joint replacement.
If you are committed to social justice, health equity, and prepared to deliver care in new, innovative ways, you belong with us.
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
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
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Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
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Equal Opportunity
CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.