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UTILIZATION REVIEW NURSE, PART-TIME, WEEKENDS

University of Washington • Part-time • Remote (Seattle, WA, US) • $8.50k - $12.50k / month • 2m ago

UTILIZATION REVIEW NURSE, PART-TIME, WEEKENDS

Req #:

236617

Department:

UW MEDICAL CENTER - UTILIZATION MANAGEMENT

Job Location:

Remote/Hybrid, UW Medical Center - Montlake, UW Medical Center - Northwest

Job Location Detail:

Position supports both UW Medical Center campuses

Posting Date:

07/10/2024

Closing Info:

Open Until Filled

Salary:

50% or 60% of $8,500 - $12,500 per month

Other Compensation:

Shift:

First Shift

Benefits:

As an employee you will enjoy generous benefits and work/life programs.

UW Medical Center has an outstanding opportunity for an experienced Utilization Review Nurse (UM RN) to join our team.

WORK SCHEDULE
Fully remote / work from home
Must be available to work day shifts during Pacific Standard Time
50% position - 20 hours/weekend (two - 10 hour shifts)
60% position - 24 hours/week (two - 8 hour shifts on the weekend plus one weekday shift)

POSITION HIGHLIGHTS
Ensures the delivery of optimal care for our Behavioral Health and med/surg patients while promoting fiscal responsibility
Maintains efficient, cost effective care management processes by determining the medical necessity and financial liability for all hospitalized patients
Plays a key role ensuring compliance with regulatory requirements, policies, and procedures

PRIMARY JOB RESPONSIBILITIES
Identify clinical indications for admission
Track hospital events and course in order to justify patient admission and continued stay for payer reimbursement
Communicate with third party payers regarding patient clinical progress
Assess and communicate potential reasons for payer denials and attempts to resolve the denial with the team at the time of identification
Participate in activities of identifying high risk vulnerabilities to the organization
Use critical thought processes and decision making in monitoring the continuum of care

REQUIRED POSITION QUALIFICATIONS
3 years of work experience in utilization management
5 years of nursing work experience in an acute care med-surg setting
Bachelor's Degree in Nursing, or equivalent education and training
Active licensure to practice as a Registered Nurse in Washington State
Knowledge of medical screening criteria
Computer skills to appropriately navigate electronic charting and referral systems

DESIRED
Case Management certification preferred
Previous experience with Xsolis software and MCG criteria preferred

ABOUT UW MEDICINE – WHERE YOUR IMPACT GOES FURTHER
UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.

All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift Northwest.

Become part of our team. Join our mission to make life healthier for everyone in our community.

Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.

The University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.

To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or dso@uw.edu.

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.