Utilization Review RN - Anne Arundel * $10.000 Sign On Bonus

Description: Job Summary:The Patient Care Coordinator is responsible for utilization review, discharge planning and transitions in care, in collaboration with MAPMG rounder in acute or alternative settings of care.Essential Responsibilities:Utilization Review
According to department policy, procedure and protocols, consistently apply and verbally communicate approved utilization review criteria and guidelines for services delivered in acute or alternative care settings.Eligibility and Benefit Verification
Confirm eligibility status and ensure the appropriate administration of benefits in accordance with department policies and procedures.Assessing Right Venue of Care with Hospitalist
Collaboration with Hospitalist to assess the appropriate level of care for patients (i.e., Medical Unit, Surgical Unit, Tele Unit, TCU, ICU) and post- (Home, Continuum or Community-based Services) hospitalization.Coordination of Care
Driving patient care plan through assuring daily plan is executed, and management of transitions and post-hospital care.Effective Discharge Planning
Prompt, clinically appropriate discharge planning beginning at time of admission.Variance Management
Timely steps in identification of delays in throughput, escalation to correct delays, and recording delays to identify patterns and trends that will require corrective actions.Quality Screening
Demonstrate competency to assess all aspects of care across the continuum for variations from quality and utilization standards.Performs other related duties as directed
Case management experience preferred
May be required to float to BWMC to backfill
Every other weekend and Holiday requirement.Basic Qualifications:ExperienceMinimum one (1) year of experience as an RN in an acute care setting.EducationN/ALicense, Certification, RegistrationThis job requires credentials from multiple states
Credentials from the primary work state are required before hire
Additional Credentials from the secondary work state(s) are required post hire.Registered Nurse License (Virginia) within 6 months of hire AND Registered Nurse License (Maryland) within 6 months of hire OR Compact License: Registered Nurse within 6 months of hireRegistered Nurse License (District of Columbia) within 6 months of hireBasic Life SupportAdditional Requirements:Annually: Successful completion of PCC Assessment of Critical Skills
Passing score on inter-rater reliability.Ability to effectively communicate.Ability to conform to established policies and procedures.Ability to analytically problem solve and make decisions.Ability to tolerate and cope with ambiguity.Ability to work as a team member.Proficiency in the use of applicable computer software.Recent acute care, case management, or home health experience preferred.Demonstrated ability to effectively and clearly present information through the written word, to influence or persuade others through oral presentation in positive or negative circumstances, and to listen well.Demonstrated ability to write clearly, legibly, and effectively, to present ideas and document activities, to read and interpret written information.Preferred Qualifications:B.S.N
preferred.