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Utilization Review Nurse RN PRN

Company: HCA
Location: Tallahassee
Posted on: December 3, 2019

Job Description:

Description SHIFT: Work From HomeSCHEDULE: PRN/Per DiemUtilization Review
Nurse (RN) - HCA North Florida Division - POSITION SUMMARY: Provide
clinical information to patient Insurance Plans according to the terms of the
contract, receive authorization / certification for the stay, work concurrent
denials, determine the correct patient status and communicate to the
facilities, follow the X-Code process per HCA policy, maintain communication
with the facility case managers, physicians and the Insurance Plans. This
position will focus on initial and continued stay utilization review and
denials to include assessment of medical records for appropriateness, level of
care provided, including assessment of treatment modalities, medications,
services and application of treatment protocols. A team approach with the
facility Case Management team is critical. - SCHEDULE: Although this is a
work-from-home position, candidates must live within the HCA North Florida Division and reside within driving distance of an HCA facility in the Orlando or Gainesville, FL areas. Schedule requirements are variable per UR department needs. - Some weekend and / or holiday work will be
required. - QUALIFICATIONS: B.S.
in Business Administration, Nursing or Healthcare Administration preferred or
equivalent work experienceRegistered
Nurse (RN) license -requiredCertification
in Case Management or UR preferred or is willing to pursue in the first year
(or when eligible)InterQual
experience strongly preferred, minimum of one
year.Acute
care hospital experience preferred.Third
Party Payer and Denial Management experience a plus.Excellent
personal computer skills (MS Outlook, MS Office, Midas, Meditech, OnBase DOS
based and other related software) required - Special Qualifications: - Able to work independently with little
supervision. Ability to communicate clearly, professionally and concisely. Excellent
critical thinking skills. Strong organizational skills and able to proactively
prioritize needs and effectively manage resources. Ability to work within a
Team. Excellent written and oral communication skills along with excellent
interpersonal skills. Position requires candidates with determined and
assertive communication skills. -About HCA:Nashville-based HCA
Healthcare is one of the nation's leading providers of healthcare services,
comprising 184 hospitals and approximately 2,000 sites of care, including
surgery centers, freestanding ERs, urgent care centers, and physician clinics,
in 20 states and the United Kingdom. With its founding in 1968, HCA Healthcare
created a new model for hospital care in the United States, using combined
resources to strengthen hospitals, deliver patient-focused care and improve the
practice of medicine. HCA Healthcare has conducted a number of clinical
studies, including one that demonstrated that full-term delivery is healthier
than early elective delivery of babies and another that identified a clinical
protocol that can reduce bloodstream infections in ICU patients by 44 percent.
HCA Healthcare is a learning health system that uses its more than 31 million
annual patient encounters to advance science, improve patient care and save
lives. - - HCA affiliated
facilities in the -North Florida Division -are a part of a
quality healthcare network in North Florida with 14 affiliated hospitals, 5
surgery centers, and two consolidated service centers. Together, the network has
over 3,100 beds, employs more than 14,000 individuals, and has over 4,200
physicians on staff. - An
EEO/AA Employer M/F/V/DNotice Our Company's recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking -here.
For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.

Keywords: HCA, Tallahassee , Utilization Review Nurse RN PRN, Healthcare , Tallahassee, Florida

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