Utilization Review RN (Utilization Review)

Description

Additional Position Details: FTE: 1.000000 | Full Time | 1st Shift - Days | This position will work every Saturday and Sunday.

Salary Range: $50.82 - $69.89

Shift Differentials:

• $2.20/hour for working weekends. *Note this position will work every Saturday and Sunday as part of a set schedule. 

Position Summary

The Utilization Review Nurse monitors utilization practices from preadmission to discharge to assure cost-effective, quality patient care and to ensure that patient, physician, and hospital/system receive maximum benefits from the health plan. Also ensures compliance with all regulatory requirements involved in the continuum of care. In this role, general responsibilities include:

• Receiving and disseminating information related to system, departmental, and patient processes
• Participating in data collection activities to support departmental programs and services
• Monitoring and reporting on patient outcomes and actively working with other members of the interdisciplinary team to facilitate improved delivery of cost-effective services
• Conducting utilization review, evaluating clinical information, and communicating findings to payors within the framework of contractual and government regulations
• Reviewing all admissions for appropriate inpatient vs. outpatient / observation status

Qualifications

• 2 recent years of progressive nursing experience in an acute care setting preferably within discharge, utilization and/or case management or equivalent combination of education and/or experience 
• RN: Registered Nurse licensed by Oregon State Board of Nursing is required upon start

Preferred Qualifications 

• Bachelor's degree in nursing 
• CCM: Certified Case Manager
• ACM: Accredited Case Manager 

Total Rewards

We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:

• Competitive Pay: Hourly and salaried positions earn market-based compensation. 
• Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
• Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
• Paid Time Off: Generous ETO for part-time and above employees.
• Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
• Additional Benefits: Life insurance, disability coverage, and employee assistance programs.

At Asante, we are guided by our values:

Excellence - Respect - Honesty - Service - Teamwork

Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.