Nurse Utilization and Reviewer
Job Description
Now offering a $1500 Sign on Bonus!
Do you have a passion for helping the under-served and behavioral health populations? Are you a dedicated, investigative and experienced Registered Nurse looking for an alternate option for providing client care? We are seeking a Utilization Manager/Utilization Review (UMUR) Nurse for Tooele and Summit Counties.
This position does not involve direct, client care. The goal of a UMUR is to control costs while monitoring the quality of patient care for our clients. This involves monitoring inpatient, residential and outpatient utilization services and trends and provide daily supervision to assigned employees. The UMUR assess and determines a standard of care is being met while utilizing appropriate, limited, financial resources. A solid knowledge base, critical thinking skills and ability to apply evidence-based guidelines are crucial. If you strive for excellence, we want to speak with you!
Location:
100 South 1000 West, Tooele, UT 84074 (with some travel to Park City)
Schedule:
M-F; 8-5 (with the option to work from home 2 afternoons a week)
Pay:
Commensurate with experience
Benefits:
Yes Valley provides a generous benefits package including retirement/savings, health and dental, health savings plans and an Employee Assistance Program. Other important benefits include life and disability insurance plans, tuition reimbursement, paid time off, sick leave, flexible spending plans and paid holidays.
We re known for helping those we serve lead more fulfilling lives. That s the focus of what we do, but we are much more. We re a growing and evolving organization that focuses on its people. At our core, we are a people powered organization. Our employees and our culture define us. Let us be the best place you ll ever work!
Responsibilities
Objectively assess and determine a standard of care is being met while utilizing appropriate, limited, financial resources.
Ensure that programs and patient care is monitored and evaluated in order to enhance accountability and improve service delivery.
Ensure that patient care programs are in compliance with local, state and federal law guidelines. Regulatory compliance is measured at 90%.
Coordinate doctor to doctor reviews
Responsible to monitor and track higher levels of care including inpatient and residential care.
o This includes monthly tracking by various criteria.
Provides consultation to providers/subcontractors as needed and requested
Monitor and minimize costs to ensure quality of care
Qualifications
Registered Nurse (RN) license current in the state of Utah
3
years of acute-care nursing experience
Experience with Utilization and Review a plus
Proficiency in Microsoft Office with the ability to learn new software programs quickly
In-depth knowledge of insurance company's policies and procedures for admissions and discharge
Ability to review and understand medical charts and to critically and efficiently decipher each piece of clinical information.
Excellent, assertive verbal and written communication skills
Proficient in Microsoft Office
Professional phone etiquetteEstimated Salary: $20 to $28 per hour based on qualifications.
Now offering a $1500 Sign on Bonus!
Do you have a passion for helping the under-served and behavioral health populations? Are you a dedicated, investigative and experienced Registered Nurse looking for an alternate option for providing client care? We are seeking a Utilization Manager/Utilization Review (UMUR) Nurse for Tooele and Summit Counties.
This position does not involve direct, client care. The goal of a UMUR is to control costs while monitoring the quality of patient care for our clients. This involves monitoring inpatient, residential and outpatient utilization services and trends and provide daily supervision to assigned employees. The UMUR assess and determines a standard of care is being met while utilizing appropriate, limited, financial resources. A solid knowledge base, critical thinking skills and ability to apply evidence-based guidelines are crucial. If you strive for excellence, we want to speak with you!
Location:
100 South 1000 West, Tooele, UT 84074 (with some travel to Park City)
Schedule:
M-F; 8-5 (with the option to work from home 2 afternoons a week)
Pay:
Commensurate with experience
Benefits:
Yes Valley provides a generous benefits package including retirement/savings, health and dental, health savings plans and an Employee Assistance Program. Other important benefits include life and disability insurance plans, tuition reimbursement, paid time off, sick leave, flexible spending plans and paid holidays.
We re known for helping those we serve lead more fulfilling lives. That s the focus of what we do, but we are much more. We re a growing and evolving organization that focuses on its people. At our core, we are a people powered organization. Our employees and our culture define us. Let us be the best place you ll ever work!
Responsibilities
Objectively assess and determine a standard of care is being met while utilizing appropriate, limited, financial resources.
Ensure that programs and patient care is monitored and evaluated in order to enhance accountability and improve service delivery.
Ensure that patient care programs are in compliance with local, state and federal law guidelines. Regulatory compliance is measured at 90%.
Coordinate doctor to doctor reviews
Responsible to monitor and track higher levels of care including inpatient and residential care.
o This includes monthly tracking by various criteria.
Provides consultation to providers/subcontractors as needed and requested
Monitor and minimize costs to ensure quality of care
Qualifications
Registered Nurse (RN) license current in the state of Utah
3
years of acute-care nursing experience
Experience with Utilization and Review a plus
Proficiency in Microsoft Office with the ability to learn new software programs quickly
In-depth knowledge of insurance company's policies and procedures for admissions and discharge
Ability to review and understand medical charts and to critically and efficiently decipher each piece of clinical information.
Excellent, assertive verbal and written communication skills
Proficient in Microsoft Office
Professional phone etiquetteEstimated Salary: $20 to $28 per hour based on qualifications.
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