Utilization Management RN
Company: UCHealth
Location: Parker
Posted on: February 19, 2021
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Job Description:
Summary:
Ensures that services are delivered and documented in a manner that
balances quality of care with efficiency, cost-containment and
compliance. Work Schedule: Part Time (20 hours a week, 40 hours per
pay period), Day Shift
Responsibilities:
Reviews admissions and service requests within assigned unit for
prospective, concurrent, and retrospective medical necessity and/or
compliance with reimbursement policy criteria.
Provides case management and/or consultation for complex cases.
Assists departmental staff with issues related to Milliman (or
similar) guidelines, status determination, medical
records/documentation, precertification, reimbursement and
concurrent denials appeals.
Collaborates closely with case managers to make sure status' and
level of care is accurate. Communicates with payers as needed to
ensure patient accounts are secured.
Assesses and coordinates patient's discharge planning needs with
members of the healthcare team. Within scope of job, requires
critical thinking skills, decisive judgement and the ability to
work with minimal supervision. Must be able to work in a fast-paced
environment and take appropriate action.
Requirements:
Are you a RN New Grad? Visit to find out about our exciting New
Grad opportunities!
At UCHealth, we do things differently
We believe in something different: a focus on the individuality of
every person. In big ways and small, we exist to improve the
extraordinary lives of all those we serve. As Colorado's largest
and most innovative health care system, we as a team deliver on the
commitment to provide the best possible experience for our patients
and their families. We foster a true human connection and give
people the freedom to live extraordinary lives. A career at
UCHealth is more than a job, it's a passion. Going beyond quality
requires the perfect balance of talent, integrity, drive and
intellectual curiosity. We are looking for individuals who
recognize, like us, that the world of medicine is ever-changing and
are motivated to do what is right, not what is easy. We support
creativity and curiosity so that each of us can find the
extraordinary qualities within ourselves. At UCHealth, we'll do
everything in our power to make sure you grow and have a meaningful
career. There's no limits to your potential here. Be Extraordinary.
Join Us Today! UCHealth recognizes and appreciates the rich array
of talents and perspectives that equal employment and diversity can
offer our institution. As an affirmative action/equal opportunity
employer, UCHealth is committed to making all employment decisions
based on valid requirements. No applicant shall be discriminated
against in any terms, conditions or privileges of employment or
otherwise be discriminated against because of the individual's
race, creed, color, religion, gender, national origin or ancestry,
age, mental or physical disability, sexual orientation, gender
identity, transgender status, genetic information or veteran
status. UCHealth does not discriminate against any "qualified
applicant with a disability" as defined under the Americans with
Disabilities Act and will make reasonable accommodations, when they
do not impose an undue hardship on the organization.
Keywords: UCHealth, Parker , Utilization Management RN, Healthcare , Parker, Colorado
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