Description

All the benefits and perks you need for you and your family:

• Benefits from Day One 

• Paid Days Off from Day One 

• Student Loan Repayment Program 

• Career Development  

• Whole Person Wellbeing Resources 

**Our promise to you: **  

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.  

Schedule: Full-time Shift: Day 

Location: AdventHealth Avista

The role you'll contribute:

Utilizes clinical expertise, discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management, and patient advocacy. Responsible for assuring medical appropriateness criteria are met for status and level of care.

The value you'll bring to the team:

• Able to identify and apply evidence-based criteria/regulatory guidelines for accuracy in establishing appropriate patient status and level of care.

• Applies medically necessary validation and may enlist physician advisor and/or Third-Party Reviewer.

• Involved with identifying LOS and projected discharge date early in admission and communicate this to the care team.

• Works with third party payers to satisfy utilization review requests and obtain approval of stays.

• Participates in providing information on outliers for length of stay and recommending proactive solutions.

• Participates in denial management with CM Manager/Director with clinical information for denial reversals.

• Performs utilization review in accordance with UM Plan to include concurrent/retro reviews and verify admission/bed status.

• Proactive management of factors influencing length of stay using critical thinking skills minimizing variance days.

• Proactive monitoring of appropriate patient status with interaction with physician for to assure correct order early in admission.

• Reviews & analyzes information relative to admission in accordance with AdventHealth policy and documents assessment using case management software and/or other clinical information system.

• Assesses patient’s physical, psychosocial, cultural, and spiritual needs through observation, interview, review of records and interfacing with patient, physician and interdisciplinary team and caregivers to assist patient/family in making decisions toward next level of care.

Qualifications

The expertise and experiences you’ll need to succeed:

Required:

• Associate degree Nursing

• Colorado Registered Nurse License

• 1 year of nursing or case management experience

Preferred:

• Bachelor’s degree Nursing, BSN

• Experience working with EMR

• Working knowledge of regulatory requirements and accreditation standards

• Basic Life Support – American Heart Association

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Nursing

Organization: AdventHealth Avista

Schedule: Full-time

Shift: 1 - Day

Req ID: 23039646

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.