Silver Cross Hospital is an extraordinary place to work. We’re known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve…and for each other. Come join us! It’s the way you want to be treated.
Position Summary: Performs medical record review for severity of illness and intensity of service; liaison function with external review agencies to ensure compliance with regulations affecting financial reimbursement; identifies variance from established pathways
Essential Duties and Responsibilities:
Collects information from clinical medical record for severity of illness and intensity of service and documents such in clinical database
Monitors all levels of care for appropriateness and communicates variance; evaluates plan of care to ensure it is based on accepted standards
Provides information to external review organizations, documents pertinent communications
Refers to designated physician advisor those patients not meeting criteria as well as quality of care concerns
Maintains knowledge and incorporates current standards into practice Required Qualifications: Knowledge of clinical norms; excellent communication skills; critical thinking skills; organized and efficient time management skills
Education and Training:
Nurse, Registered (RN) licensure
BSN preferred. 2-5 years previous Utilization Review experience preferred.
Current CPR
Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred
Work Shift Details:
Registry, Registry 48 hours per 6 week schedule block; remote; on site requirement for mandatory trainingDepartment:
CONTINUUM OF CAREBenefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:
· Medical, Dental and Vision plans
· Life Insurance
· Flexible Spending Account
· Other voluntary benefit plans
· PTO and Sick time
· 401(k) plan with a match
· Wellness program
· Tuition Reimbursement
Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
The expected pay for this position is listed below:
$43.00 - $43.00
Silver Cross Hospital is a healthcare provider known for its culture of excellence and delivery of high-quality patient experiences. The hospital provides comprehensive medical services to patients and their families across the communities it serves. The organization is committed to creating an exceptional workplace environment where employees are treated with the same care and respect they extend to patients. Silver Cross Hospital operates with a focus on clinical excellence, compliance with healthcare regulations, and maintaining accepted standards of care.
