Registered Nurse (RN) - Behavioral Health Utilization Review

Job Type: Per Diem

Job Shift: Rotate

Holiday Rotation: 

Department: Behavioral Health

Position Summary                        

Reporting to the Director of Case Management, the Utilization Review Nurse is responsible for ensuring that patients being admitted to Doctors Behavioral Health Center are admitted to the appropriate level of care in accordance with the vision and goals of Doctors Medical Center and the regulatory guidelines as set by the state and federal rules.  The Utilization Review Nurse ensures quality, cost-effective patient care through planning; communication, critical thinking and facilitation of the multi-disciplinary patient care team. Coordinates Utilization Review activities to ensure that authorizations are obtained for in-patient acute hospitalizations. Acts as a liaison between MD’s, the Treatment Team and External Review Organizations. Reviews the Treatment Plan and monitors the delivery of care to make sure the desired treatment outcomes are achieved.. Communicates reimbursement issues, trends and patterns to the Director of Case Management and the Administrator.                        

Minimum Education:        

BSN preferred.

 

Minimum Experience/Skills:        

One or more year’s recent acute hospital experience Minimum of one year acute, inpatient psychiatric or chemical dependency experience. Good communication, documentation and organizational skills. Self motivated and able to function with a minimum of supervision. Demonstrates personal maturity, independent judgment and integrity.

 

License/Certificates/Credentials:        

Current CA Registered Nurse License

Current BLS certification              

#LI-ML2