RN Utilization Management - Manager

Company: All Children's Hospital
Location: Saint Petersburg
Posted on: September 20, 2022

Job Description:

RN Utilization ManagementRN Utilization Management

Requisition #: 585024

Location: Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701

Category: Nursing

Work Shift: Day Shift

Work Week: Full Time

Weekend Work Required: No

Date Posted: Sept. 14, 2022

POSITION SUMMARY:

The purpose of the RN-Utilization Management position is to collaborate with various internal and external stakeholders to advocate for the patient and ensure high quality, cost-effective care. Contributes to the goals of the department by examining appropriateness of status and level of care for the patient's clinical condition, improving coordination of care across the continuum, and aiding in optimization of financial performance to allow for continued reinvestment in JHACH. Uses clinical findings, Interqual evidence based criteria and JHACH policies/practices to perform utilization reviews for admissions, continued stays, and adverse determinations following escalation process defined in the JHACH UM Plan.

Work Location: St. Petersburg, FL

Work Hours: 8a-4:30p (weekend work required)

QUALIFICATIONS:

* Current Florida RN licensure
* BSN
* 2 years of pediatric acute hospital experience required. Case Management and/or Utilization Management experience preferred.
* Excellent critical thinking, decision-making and problem-solving skills
* Excellent interpersonal and communication skills with the ability to work with diverse individuals
* Writing and computer skills to include accurate typing skills, proficiency in Windows, Microsoft word, Outlook, and Excel, electronic medical record, and other clinical platforms
* Works well under pressure and manage stress effectively
* Strong working knowledge of healthcare financial systems

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Keywords: All Children's Hospital, St. Petersburg , RN Utilization Management - Manager, Executive , Saint Petersburg, Florida