Providence Health & Services Care Management RN Medical Clinical Appeals in Olympia, Washington
Providence is calling a Registered Nurse to support the Care Management/Utilization Review Department at Providence St. Peter Hospital in Olympia, WA. This is a full time (1.0) Day Shift position.
We are seeking a compassionate individual to help facilitate coordination and communication between all members of the health care team, in the decision making process to minimize fragmentation of the health care delivery system.
In this position you will:
Facilitate the local appeal process for medical and experimental denials.
Perform medical reviews/audits, analyze audit results and report findings to promote and improve processes.
Promote coordination of care and patient advocacy.
Be responsible for the achievement of consistent and/or expected clinical conditions.
Be responsible for efficient resource management.
Required qualifications for this position include:
Associates Degree in Nursing.
Three (3) years of experience in nursing required with prior experience in Utilization Review, Home Health, Quality Management and / or Discharge Planning
Washington State Licensure as a Registered Nurse.
Strong background in the use of system software for documentation.
Understanding of regulatory compliance in a healthcare setting.
Preferred qualifications for this position include:
Bachelors Degree in Nursing or a related field or Master’s degree in health care or business administration a plus.
Experience in hospital and/or intergrated healthcare system.
Familiarity with Revenue Cycle processes.
About the hospital you will serve.
Providence St. Peter Hospital is a 390-bed, not-for-profit regional teaching hospital. Located in Olympia, WA, St. Peter offers comprehensive rehabilitation, medical, surgical and behavioral health services. We have been ranked as one of the top 100 hospitals and as one of 10 premier healthcare employers in the nation and have recently achieved the coveted Magnet®" recognition from the American Nurses Credentialing Center®. Our hospital rests on a 173-acre campus, much of which includes natural forest and preserved wetlands that maintain a healing environment for patients and staff.
We offer a full comprehensive range of benefits - see our website for details
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 Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. 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: Nursing - Other
Req ID: 178824