What are the responsibilities and job description for the Registered Nurse (RN) - Utilization Review position at Dartmouth Health?
Utilization Review (RN) - Remote
Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process.
* UR experience preferred
These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in New Hampshire.
- We have loan repayment up to $20,000.
- We offer Relocation Assistance and a Housing Coordinator to take on the burden of finding a home.
- We offer generous tuition reimbursement.
- We have a very popular "earned time" plan.
- We have extensive CEU/Training programs.
- Our 8,000 ft Patient Safety and Training Simulation Center is state-of-the-art.
- Our nurses serve as central figures in the success of our system through our shared governance nursing model.
- We offer a rigorous, research-focused environment.
- Dartmouth Hitchcock's Nursing Continuing Education Council is accredited as a provider of continuing nursing. education by the American Nurses Credentialing Center.
Why are we so unique? We are a nationally recognized Academic Medical Center set right in the middle of the White Mountains of New Hampshire. We recognize that “quality of life” means different things to different people, but we are very confident you will love it here as we have beautiful, rural and suburban housing options, world-class primary, secondary, and graduate schools, hundreds of lakes, thousands of miles of hiking trails and some of the best skiing in the country. This all means you can be a happy nurse with more quality time with friends, family, pets or maybe just quiet hikes by yourself. Our idea of traffic in the “Upper Valley” of New Hampshire is a line on the ski mountain at the chair lift.
Read more about Dartmouth Health and why YOU should work here.
The Dartmouth Health system stretches over New Hampshire and Vermont and offers the quintessential New England experience. With no income or sales tax, this beautiful area combines history, industry, and business and has been ranked consistently as one of the best places in the US to live and work. Anchored by the academic Dartmouth Hitchcock Medical Center in Lebanon, NH, the system includes the NCI-designated Dartmouth Cancer Center, Dartmouth Health Children’s; 4 member hospitals, and 30 Dartmouth Hitchcock ambulatory clinics across the region. With destinations like Boston, New York, the seacoast, and ski country within driving distance, the opportunities - both career and personal - truly make New Hampshire the ideal place to work and play.
Applicants are encouraged to visit our nursing career site to learn more and apply:
Please visit: https://dhnursing.org/nursing-careers/
Dartmouth Health is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, veteran status, gender identity or expression, or any other characteristic protected by law.
Responsibilities
- Works with Medical Director and appropriate physician(s) to establish Dartmouth-Hitchcock (D-H) ambulatory and inpatient procedure list, updates and maintains list.
- Reviews reservation forms and the log of emergent and urgent admissions daily.
- Identifies areas that require intervention and education around the use of definitions.
- Reviews “one day stays” to assess appropriate use of level of care (LOC) determinations.
- Works with individual physicians and office staff when they are experiencing discrepancies with pre-certifications.
- Assumes responsibility for the oversight of inpatient denials, including, but not limited to, reviewing denial letters, collaborating with the Medical Director and appropriate physicians to determine the decision to appeal or accept, assisting in the response to Health Plan, etc.
- Develops and implements communication strategies to keep clinicians and staff informed of changes and current practice.
- Works closely with others to transition level of care determinations.
- Provides information to departmental leadership that reflects trends and practices that may need organization, intervention, and change.
- Collaborates with Health Plans to understand their definitions, articulates the definitions of D-H, and assists in the development of strategies for resolution of differences.
- Benchmarks with other facilities concerning admission and denial experience and policies.
- Performs other duties as required or assigned.
Qualifications
- Graduate from an accredited Nursing Program required.
- Bachelor of Science Degree in Nursing (BSN) with 3 years of experience.
- Masters of Science Degree in Nursing (MSN) preferred.
- Strong leadership, communication and computer skills desired.
Required Licensure/Certifications
- Remote: Fully Remote
- Area of Interest: Nursing
- Pay Range: $79,747.20/Yr. - $127,587.20/Yr.
- FTE/Hours per pay period: 1.00 - 1.00 - 40 hrs/week
- Shift: Day
- Job ID: 29683
Dartmouth Health is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
Salary : $79,747 - $127,587