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Rural Health Job Opportunity: Utilization Review Registered Nurse

Salary: Open
Type: Full Time - Experienced
Sector: Hospital, Public and Private
Discipline: General Nursing
Required Education: RN

The Utilization Review RN is responsible for prospective, retrospective and concurrent Utilization Review activities. He/She is a member of the Multidisciplinary Team, and monitors the documentation for accuracy and clinical compliance.

He/She is also responsible for organizing, directing and coordinating Utilization Review activities within the facility in accordance with standards of State and Federal regulations; and in accordance with accreditation and payor guidelines.

Specific Job Duties Include:

•Adheres to and refers to Policy and Procedure Manual and other resource materials, as needed, for direction.

•Works closely with center staff, providing feedback, as necessary, regarding findings or reviews.

•Provides in-service and education training for staff regarding documentation and Performance Improvement.

•Interacts with third party payors, managed care organizations and gatekeeper organizations as appropriate on a case-by-case basis and maintains detailed documents of all interactions with said parties representatives.

•Performs supervisor assigned and random clinical reviews on patient records; report findings to Clinical Programs Director and Vice President of Clinical Operations.

•Assists in formulating corrective action plans, as necessary, to comply with Utilization and/or Performance activities.

•Communicates with the Vice President of Clinical Operations when Utilization problems are identified and cannot be resolved at the facility level.

•Maintains records, data and statistical analysis of all Utilization Review activities.

•Designs, implements and evaluates the Utilization Review Plan and provides feedback and input on an annual basis.

•Assists in the development of policies and procedures; review policies and procedures periodically.

Requirements:

•Must be a Registered Nurse in FL.

•Experience in Behavioral Health Care and knowledge of the ASAM criteria a plus.

•Expertise in CD/Psych or both.

•Previous working experience in UR a plus.

•Excellent verbal and written skills.

•Expertise in Psychiatric and Addictions Disorders.

•Excellent organizational skills.

 

The Watershed welcomes recovering individuals to apply! Recovering individuals must have a minimum of 1 full year of abstinence from drugs/alcohol to be eligible for employment.

Our competitive compensation and excellent benefits package for Full Time Employees includes:

Medical and Dental Insurance

Supplemental Insurance

401(k) Plan

Paid Time Off (PTO) Plan

The Watershed Addiction Treatment Programs, Inc. is an Equal Opportunity Employer and maintains a drug free workplace. Local candidates desired. No relocation offered

 

•Must be a Registered Nurse in FL.

•Experience in Behavioral Health Care and knowledge of the ASAM criteria a plus.

•Expertise in CD/Psych or both.

•Previous working experience in UR a plus.

•Excellent verbal and written skills.

•Expertise in Psychiatric and Addictions Disorders.

•Excellent organizational skills.

NOTES:

2 openings.

Additional Salary Information: will be discuss during interview

Internal Number: 65

Apply here