[Hiring] Utilization Review RN @CommonSpirit Health

Role Description

As a RN Care Coordinator, you are responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.

• Leverage your expertise to provide individualized, comprehensive care.
• Make critical assessments and perform skilled procedures.
• Meticulously implement patient care plans.
• Collaborate seamlessly within an interdisciplinary team.
• Focus on optimal patient outcomes.
• Possess keen assessment skills and acute critical thinking.
• Maintain a patient-first mindset, driven by a profound enthusiasm to help others.
• Support patient recovery and fuel your own career advancement.
• Advocate for the patient and family by identifying, valuing, and addressing:
• Patient choice
• Spiritual needs
• Cultural, language, and socioeconomic barriers to care transitions
• Strive to enhance the patient experience.

Qualifications

• Graduate of an accredited school of nursing.
• Minimum two (2) years of acute hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of 1 year experience.
• RN license in the state(s) covered is required.
• BLS required within 3 months of hiring.
• Preferred: Bachelor's Degree in Nursing (BSN) or related healthcare field.
• At least five (5) years of nursing experience.
• Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred.

Requirements

• Able to apply clinical guidelines to ensure progression of care.
• Knowledge of managed care and payer environment preferred.
• Must have critical thinking and problem-solving skills.
• Collaborate effectively with multiple stakeholders.
• Professional communication skills.
• Understand how utilization management and case management programs integrate.
• Ability to work as a team player and assist other members of the team where needed.
• Thrive in a fast-paced, self-directed environment.
• Knowledge of CMS standards and requirements.
• Proficient in prioritizing work and delegating where indicated.
• Highly organized with excellent time management skills.

Company Description

Mercy Medical Center Redding offers comprehensive health care to nearly 300,000 residents in a six-county region. It is one of only two Level II trauma centers, the only Level III Neonatal Intensive Care Unit (NICU), and the only Joint Commission-certified Advanced Thrombectomy-Capable Stroke Center north of Sacramento.

• 266-bed regional medical center providing inpatient and outpatient services.
• Specialized cardiovascular care, stroke care, orthopedics, neurological surgery, comprehensive cancer care, maternity care, and a robust robotic surgery program.
• Network of care includes Mercy Home Health and Hospice and Dignity Health Connected Living.

One Community. One Mission. One California.