Providence is calling a RN, Utilization Reviewer to the Utilization Department at Providence Kodiak Island Medical Center in Kodiak, AK.
Partners with patients and physicians and staff to obtain authorization from third party payors and assure access, services, and transition for the continuum of care.
In this position you will:
- Work as team member with health care professionals, community resources, liaisons, and families to provide coordinated admission and discharge planning.
- Partner in identifying and achieving timely patient care needs with implementation of the plan of care that is appropriate, resourceful, and valuable.
- Effectively utilize tools that measure, monitor, and manage quality and stewardship of patient care resources.
- Assist in decreasing liability risk factors for the institution by applying quality screens to medical records and analyzing data for potential risks.
- Educate, consult for, and learn from the Medical Staff and other health care providers in regards to the fiscal impact of their practice.
- Provide at least two shifts per month weekend coverage.
Required qualifications for this position include:
- Graduate from an accredited school of Nursing or graduate from an accredited college or university with a minimum of an Associate's degree in a clinical healthcare field.
- Must maintain current licensure in a clinical healthcare field.
- Two years of clinical experience.
- Thorough knowledge of provider requirements for admissions, transfers, and discharges.
- Must have ability to communicate (written and verbal) well and interact with multiple health care professionals, including medical and allied staff.
- Organizational and problem-solving skills, as well as the ability to work independently, and as a team member needed.
- Must be able to work well with ill, disabled, elderly, and emotionally distressed patients/families.
Preferred qualifications for this position include:
- Bachelor's degree.
- Certification in Case Management.
- Three years of clinical experience.
- One year of Utilization Management-review and Discharge-planning experience.
About the ministry you will serve:
Providence Kodiak Island Medical Center (PKIMC) provides comprehensive health care to residents and visitors of Kodiak Island.
This critical access hospital features 25 acute care beds, including four birthing suites, two psychiatric care beds and two ICU beds. In addition, the Care Center, PKIMC's extended care facility, has 19 long-term care beds.
PKIMC provides an extensive array of inpatient and outpatient services, including emergency department, surgery, laboratory services, maternity, general medicine, physical therapy, occupational therapy, respiratory therapy, sleep studies, specialty clinics, diagnostic imaging services and pharmacy.
It is staffed by a mix of primary care physicians, surgeons and specialists who provide family practice, internal medicine, obstetrics, radiology and general practice.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. 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.
Schedule: On Call
Job Category: Audit / Legal / Risk
Req ID: 140890