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Wed Oct 11, 2017 - 1 week ago

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RN (PRN) - West Chester Hospital - Utilization Review

*Primary Purpose*: The RN-Utilization Review nurse will use established criteria and policy/procedures to perform pre-admission, admission, and continued stay reviews on inpatient and observation cases in a timely manner. UR Nurse will work with hospital Care Management staff, Social Work, and Revenue Cycle team members, as well as with managed care agencies to assure certification of the patient's entire stay so that hospital receives maximum reimbursement.

* Knowledge and Skills *
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*Education:* RN with current license minimum required; BSN preferred
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*Years of Experience:*3 - 5 Years equivalent experience minimum required

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*Required Skills and Knowledge:*Knowledge of level of care management, established criteria sets, discharge planning, home health care, and case management required; basic knowledge of third party payers preferred.
Knowledge of and ability to apply clinical decisions and medical necessity criteria.
Ability to effectively communicate with and gain cooperation of resident and attending physicians with regards to documentation needs and to effectively influence all members of the interdisciplinary care team during difficult cases to achieve appropriate resolutions.
Effective written and verbal communication skills required for establishing and maintaining relationships.
Ability to interpret medical data as documented.
Strong organizational skills to manage multiple, complex activities with tight deadlines, establish priorities and manage time effectively.
Effective conflict resolution and negotiation skills.
Knowledge and training in multiple computer systems required to perform position responsibilities (i.e. EPIC, Midas, Microsoft Office, etc.).
Demonstrates initiative and responsibility for professional nursing practice.
Maintains excellent customer service attitude.

*License and Certification:* Current RN license in Ohio

**Title:** *RN (PRN) - West Chester Hospital - Utilization Review*

**Location:** *West Chester Hospital - 7700 University Dr - West Chester, OH*

**Requisition ID:** *045226*