Registered Nurse (RN) - Behavioral Health Utilization Review

Overview



Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion for nursing to a place where it truly matters!

At Doctors Medical Center of Modesto, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Job Type: Per Diem

Job Shift: Rotate

Holiday Rotation:

Department: Behavioral Health

Position Summary
Reporting to the Director of Case Management, the Utilization Review Nurse is responsible for ensuring that patients being admitted to Doctors Behavioral Health Center are admitted to the appropriate level of care in accordance with the vision and goals of Doctors Medical Center and the regulatory guidelines as set by the state and federal rules. The Utilization Review Nurse ensures quality, cost-effective patient care through planning; communication, critical thinking and facilitation of the multi-disciplinary patient care team. Coordinates Utilization Review activities to ensure that authorizations are obtained for in-patient acute hospitalizations. Acts as a liaison between MD’s, the Treatment Team and External Review Organizations. Reviews the Treatment Plan and monitors the delivery of care to make sure the desired treatment outcomes are achieved.. Communicates reimbursement issues, trends and patterns to the Director of Case Management and the Administrator.

Qualifications

Minimum Education:

BSN preferred.

Minimum Experience/Skills:

One or more year’s recent acute hospital experience Minimum of one year acute, inpatient psychiatric or chemical dependency experience. Good communication, documentation and organizational skills. Self motivated and able to function with a minimum of supervision. Demonstrates personal maturity, independent judgment and integrity.

License/Certificates/Credentials:

Current CA Registered Nurse License
Current BLS certification

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Organization Description

Doctors Medical Center (DMC), part of the Central Valley Doctors Health System, is the largest full-care hospital between Stockton and Fresno, and from the Sierras to the San Francisco Bay Area, with a 394-bed general acute care and a 67-bed inpatient psychiatric capacity. DMC is known for providing comprehensive inpatient, outpatient and emergency care. Doctors Medical Center offers a wide range of services including cardiology, neurosurgery, orthopedics, emergency and trauma services, minimally-invasive and robotic surgery, women and childrens services, medical/surgical, behavioral health, oncology and critical/intensive care. Join our team!

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