Raisso is seeking a travel nurse RN Utilization Review for a travel nursing job in Tuba City, Arizona.
Incumbent serves as an Outpatient/Inpatient Case
Manager/Utilization Review Registered Nurse (CM/UR RN) for TCRHCC and is
responsible for direct supervision and supportive contact for the specific
group of identified patient assignments and high-risk patients. The CM/UR RN is responsible for designing and
managing a continuum of care focusing on empowering clients to achieve
demonstrable outcomes and self-sufficiency.
The CM/UR RN is responsible for assessment, service planning, and
resource acquisition, monitoring progress and initiating and responding to
emerging client needs. The CM/UR RN
performs Utilization Review and Management/Clinical Documentation Chart Reviews
of patients in the acute clinical care setting, ambulatory care setting and
will conduct UR reviews as required. The CM/UR RN will work closely with the
Social Work (MSW) Case Manager on Discharge Planning and Care Transitions. The CM/UR
RN will work closely with the Physician Advisor and participate on the UR
Committee as well as conduct Clinical Documentation Chart Reviews related to
peer review, financial or insurance determination, or claims denials. The CM/UR
RN will link the client with Community Social Service providers, health care
providers, substance abuse, and mental health providers to achieve specific
goals. The CM/UR RN will have experience
working with culturally diverse low-income populations having multiple barriers
to self-sufficiency such as: illiteracy, welfare dependency, domestic violence,
substance abuse, and mental health issues.
The CM/UR RN will work with a multidisciplinary team within the service
delivery setting. The CM/UR RN will be
committed to Case Management Services and have some collaboration with
Purchased and Referred Care (PRC) formally known as Contract Health Services,
providing assistance with the PRC Case Specialist. The CM/UR RN will be responsible to the
Director of Care Coordination.
NECESSARY
QUALIFICATIONS
Education:
· Associates Degree in Nursing (ADN), must obtain bachelor’s in nursing within two (2) years
of hire
· License/Certification:
· Must have and maintain current Basic Life Support (BLS) certification by the
American Heart Association (AHA) throughout employment
· A valid, current, full and unrestricted Professional Nursing License to practice as
a Registered Nurse (RN) in any state of the United States of America, The Commonwealth
of Puerto Rico, or a territory of the United States
Experience:
· Three (3) years of clinical nursingexperience performing direct patient
care with at least 2 years in an Inpatientsetting on a medical-surgical unit, PACU,
or higher acuity Inpatient unit (ICU, Step-Down, Telemetry, etc.) or home
health (direct care) {clinical experience qualification may be determined by
hiring manager/director.}
· Demonstrate knowledge of the case management, purchased referred care and utilization reviewprocesses.
· Demonstrate knowledge of electronic health record systems.
*Must have 1 year of traveling experience as contractor*
Driven by passion, integrity, and ambition, Raisso is a nationwide leader in healthcare talent acquisition. Our commitment to diversity, inclusivity, and innovation empowers us to connect businesses with exceptional healthcare professionals, ensuring the highest standards of care.
With over 15 years of experience, we have earned a reputation as one of the most trusted names in healthcare talent acquisition, efficiently meeting workforce demands across all 50 states through our extensive network of skilled and dedicated professionals.
In a rapidly evolving industry, adaptability is key. At Raisso, we foster a culture of innovation and problem-solving, where continuous learning and growth are at the heart of everything we do. Feedback, reflection, and collaboration drive our pursuit of excellence, ensuring we uphold our guiding principles in every endeavor.
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