Utilization Review RN Case Manager - Contingent - Allegiance Health
Jackson, MI 
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Posted 8 days ago
Job Description

Position Summary:

Under minimal supervision, reviews and screens for the appropriateness of services, the utilization of hospital resources and quality of patient care rendered at Henry Ford Allegiance Health. Combines clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification and education, facilitates the quality of health care delivery in the most cost effective and efficient manner.

Minimum Education:

Current enrollment in a Bachelor's in Nursing (BSN) program, or active pursuit (defined as enrolled within 6 months of hire) of a BSN degree with the completion of three (3) semester hours during the first year of employment. Must remain enrolled in BSN program and complete six (6) semester hours annually until degree is obtained.
Minimum Work Experience:
Recent clinical experience with specific patient population.
Required Licenses/Certification:
Registered Nurse with a valid, unrestricted State of Michigan License.

Required Skills, Knowledge, and Abilities:

Knowledge of the acute care provided to neonate, pediatric, adolescent, adult, and geriatric patients.

Ability to function successfully and independently in an extremely challenging environment.

Must be self-directed, flexible, committed to teamwork.

Must demonstrate initiative and willingness to learn.

Demonstrates leadership ability, communications, and interpersonal skills necessary to interact effectively with physicians, management, staff, external agencies/customers and patients/families.

Must possess analytical, data management and computer skills.

Preferred Qualifications:

Bachelor's degree in Nursing (BSN).

Case Management certification.

Utilization management and discharge planning experience for the acute care or post- acute care setting.


Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
Open
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