Providence Care Management RN - Utilization Review in Centralia, Washington
Providence is calling a Care Management RN (1.0 FTE, Variable Shift) to work in Utilization Review at Providence Centralia Hospital in Centralia, WA.
The Utilization Review RN provides assessment and analytical support to concurrent and retrospective quality and utilization activities, in accordance with the Providence Hospital Quality and Utilization Plans, Medicare regulations, The Joint Commission regulations, guidelines and direction received from Administration and the Medical Staff.
In this position you will:
Provides concurrent review of inpatient records to identify opportunities to improve coordination of clinical care to reflect appropriate patient severity of illness and complexity and to ensure patient is in the correct care setting to optimize patient outcome.
Provides accurate and thorough concurrent quality review screening for adverse patient occurrences and indicators as directed by the medical staff and/or administration.
Identifies and refers cases for medical staff quality review as appropriate.
Assists in the development, data retrieval, and analysis of medical staff quality improvement and utilization studies.
Provides accurate and thorough concurrent utilization review of inpatient and observation patient hospitalizations, assessing necessity and appropriateness of admission utilizing InterQual criteria
Actively participates in multi-disciplinary quality and utilization activities.
Assumes utmost attention to the presentation of patient, staff and physician confidentiality in accordance with quality management policy.
Performs other related duties as requested
Required qualifications for this position include:
Associate's Degree in Nursing.
Current Registered Nurse (RN) licensure in Washington State.
Three years in medical/surgical (or comparable acute care) nursing experience.
Preferred qualifications for this position include:
Bachelor of Science Degree in Nursing (BSN).
One year recent acute care experience.
Quality and or utilization review and or case management experience.
Microsoft Office (Word and Excel) experience.
About the hospital you will serve:
Providence Centralia Hospital in Centralia, Washington is a 127-bed, not-for-profit hospital providing emergency, diagnostic, cancer, birthing and surgical services. It consistently receives high scores on accreditation surveys by the Joint Commission, the Washington Department of Health (DOH) and the Washington Department of Social and Health Services (DSHS).
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Case Management
Req ID: 284789