Transforming Healthcare through Compassionate Case Management
At Steward Health Care, a leading healthcare provider, we're committed to delivering high-quality patient care through innovative and collaborative approaches. We're seeking an experienced and skilled Registered Nurse to join our team as a Case Management Utilization Review RN, working remotely for Workwarp. This full-time opportunity offers a competitive salary and the chance to make a meaningful difference in the lives of our patients.
About Us
Steward Health Care is a renowned healthcare organization dedicated to providing exceptional patient care and advancing the healthcare industry through cutting-edge practices and technologies. Our team of healthcare professionals works together to ensure that our patients receive the best possible care, from pre-hospitalization to post-discharge. We're now expanding our team to include a talented Case Management Utilization Review RN who will play a critical role in our care coordination efforts.
Key Responsibilities
As a Case Management Utilization Review RN, you will be responsible for ensuring that our patients receive high-quality, cost-effective care. Your primary duties will include:
- Utilizing a systematic methodology to assess, plan, implement, and evaluate patient care coordination across the care continuum.
- Collaborating with physicians, clinicians, and other healthcare professionals to ensure that patients receive timely and appropriate care.
- Assessing the medical necessity, quality, and cost-effectiveness of proposed hospital, medical, and surgical services.
- Communicating with payers to obtain authorization for patient stays and services.
- Identifying and planning strategies to optimize inpatient length of stay and resource utilization.
- Developing and maintaining physician profiles to identify over/under utilization patterns.
- Supporting Steward Health Care's and hospital goals and objectives, working within regulatory compliance guidelines.
- Collaborating with the multidisciplinary team to assist patients with benefits management.
Essential Qualifications and Skills
To succeed in this role, you will need:
- A Bachelor's degree in Nursing; a Master's degree is preferred.
- Three to five years of acute medical/surgical experience, plus three to five years of Case Management experience.
- A current RN license; Certification in Case Management (CCM) is strongly preferred.
- Strong knowledge of Microsoft Office applications, including Word, Excel, Access, and PowerPoint.
- Proficiency in computer-based charting and other clinical and non-clinical software programs.
- Excellent communication, leadership, and critical thinking skills.
- The ability to work independently and remotely, with a proactive approach to problem resolution.
- Understanding of CMI, patient status, InterQual Criteria, Milliman Criteria, and Transfer DRGs.
Preferred Skills and Competencies
In addition to the essential qualifications, we prefer candidates with:
- Experience working in a fast-paced, dynamic healthcare environment.
- Strong analytical and problem-solving skills, with the ability to interpret complex data.
- Effective mentoring, coaching, and counseling skills.
- The ability to advocate for patients and navigate complex healthcare systems.
- A commitment to delivering high-quality patient care and advancing the healthcare industry.
Career Growth Opportunities and Learning Benefits
At Steward Health Care, we're dedicated to supporting the ongoing development and growth of our team members. As a Case Management Utilization Review RN, you will have access to:
- Ongoing training and education opportunities to enhance your skills and knowledge.
- Career advancement opportunities within our organization.
- A collaborative and supportive work environment that fosters professional growth.
Work Environment and Company Culture
As a remote worker for Workwarp, you will be part of a dynamic team that values flexibility, innovation, and collaboration. Our company culture is built on a foundation of:
- Compassionate care and a commitment to delivering exceptional patient experiences.
- Innovative approaches to healthcare delivery and care coordination.
- Collaboration and teamwork across disciplines and departments.
- Ongoing learning and professional development.
Compensation, Perks, and Benefits
We offer a competitive salary and a comprehensive benefits package that includes:
- A competitive salary structure.
- Opportunities for professional growth and development.
- A dynamic and supportive work environment.
- Comprehensive benefits, including health insurance, paid time off, and retirement savings options.
Join Our Team
If you're a motivated and compassionate Registered Nurse looking for a challenging and rewarding opportunity, we encourage you to apply for this Case Management Utilization Review RN position. As a member of our team, you will play a critical role in delivering high-quality patient care and advancing the healthcare industry. Apply now to join our team and start making a difference in the lives of our patients!
Apply Now