City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Healthcare is hiring a Full-Time Weekday Day shift

Mon-Fri, 8-hour shift

Utilization Review Nurse Case Management 

for the Revenue Cycle Center in Norfolk, VA.

As a Utilization Review Nurse with Sentara, you get to work together in an intensely collaborative way with the patients, family, and members of the medical team to provide patients with the resources they need and help prevent them from readmitting to the hospital. This position's primary duty is customizing what is best for the patients. That would include helping with things like home health, long-term care placement, home medical equipment, and homeless and community resources. You will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients.

Click https://youtu.be/3BE5pC5IfYo to hear Meredith tell us about a day in the life of a Utilization Review RN/Integrated Care Manager with Sentara Healthcare. 

• As a Utilization Review Nurse specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure. 
• Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review.
• Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements. 
• Responsible for written and /or verbal communication of pertinent clinical information. 

Qualifications:

*Required-- Minimum of 3 years of nursing, acute care experience

*Valid RN License

Skills:

Required – Verbal and Written Communication, Critical Thinking, Proficiency with basic computer skills

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity.

Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! 

Benefits: Sentara offers an attractive array of full-time benefits including Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more. 

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. 

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

keywords: Indeed, LinkedIn, Nursing Acute Care, Full Time, Case Management, RN, Registered Nurse, BSN, ASN, utilization review, patient accounts, revenue cycle, Talroo-Nursing, Monster, care coordinator, care coordinator, appeals, prior authorizations

Job Summary

Responsible and accountable for the provision and facilitation of comprehensive care coordination services and quality outcomes for patients across the continuum. Promotes effective utilization and monitoring of health services, collaborates and communicates with the healthcare team and patient/caregiver to manage care and transitions. Develops and/or implements a comprehensive care plan based on assessment and evaluation of patient/caregiver needs. Functions in one of the following practice settings: Acute Care, Service Lines, Ambulatory/Community-based, Home Health, and Long Term Care.

BLS required within 90 days of hire and maintained thereafter (if in clinical setting)

In Behavioral Health - De-escalation and physical intervention training within 15 days of hire.

Qualifications:

N-2YR - RN-Associate's Degree, N-3YR - RN-Diploma (Non-degree), N-4YR - RN-Bachelor's Level Degree, N-6YR - RN-Master's Level Degree

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