AllentownRecruiter Since 2001
the smart solution for Allentown jobs

RN - Utilization Management

Company: ZolonTech
Location: Allentown
Posted on: August 15, 2019

Job Description:

Contract Duration - 3+ months Under the direction of a designated Manager o, performs telephonic review of hospital admissions, recommending alternative levels of care when appropriate. Works to add value to healthcare by encouraging efficient and high quality use of the healthcare delivery system. Promotes timely and dynamic discharge planning to facilitate early discharge and refers cases to Case Management when indicated. Efficiently collaborates with the hospital utilization review department, attending physicians and members/families as appropriate. DUTIES AND RESPONSIBILITIES: Performs telephonic utilization management for inpatient admissions . Using the medical software criteria, establish the need for inpatient, continued stay and length of stay. Directs the delivery of care to the most appropriate setting, while maintaining quality. Contacts attending physicians regarding treatment plans/plan of care and clarifies medical need for inpatient stay or continued inpatient care Identifies inpatient admissions no longer meeting criteria and refers care to plan Medical Directors for evaluation. Presents cases to Medical Directors that do not meet established criteria and provides pertinent information regarding member's medical condition and the potential home care needs. Performs early identification of hospitalized members to evaluate discharge planning needs. Collaborates with hospital case management staff, physician and family to determine alternative setting at times and provide support to facilitate discharge to the most appropriate setting. Identifies and refers cases for case management and disease management. Identifies quality of care issues including delays in care. Appropriately refers cases to the Quality Management Department and/or Care Management and Coordination Supervisor when indicated. Maintains the integrity of the system information by timely, accurate data entry. Utilization decisions are in compliance with state, federal and accreditation regulations. Works to build relations with all providers and provides exceptional customer service. Reports potential utilization issues or trends to designated supervisor and recommendations for improvement. Participates in the process of educating providers on managed care. Performs additional related duties as assigned. Education and experience: Registered Nurse/BS preferred. Minimum of three (3) years of acute care clinical experience in a hospital or other health care setting. Prior discharge planning and/or utilization management experience is desirable. Skills: Exceptional communication skills on all levels Proficiency in using computerized applications Problem solving ability Organized, demonstrated excellent team management skills Team Player

Keywords: ZolonTech, Allentown , RN - Utilization Management, Executive , Allentown, Pennsylvania

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


EY Digital Studio - Experience Design Senior Manager
Description: Job Description The Digital practice works with clients to analyze, formulate, design, mobilize and drive strategic transformation initiatives. We also have the unique ability to help our clients translate (more...)
Company: EY
Location: New York
Posted on: 08/20/2019

Sales Manager, Buenos Aires
Description: Sales Manager - Buenos AiresPayoneer's mission is to empower businesses to--go beyond----- beyond borders, limits and expectations. In today's digital world, Payoneer enables businesses of all sizes from (more...)
Company: VIOLA
Location: New York
Posted on: 08/20/2019

Director of Operations, Americas
Description: Director of Operations, AmericasPayoneer's mission is to empower businesses to--go beyond--- beyond borders, limits and expectations.In today's digital world, Payoneer enables businesses of all sizes (more...)
Company: VIOLA
Location: New York
Posted on: 08/20/2019


Facilities Manager
Description: Company DescriptionNon Profit OrganizationJob DescriptionFacilities ManagerNon-Profit Organization located in Brooklyn seeks a Facilities Manager for an immediate long term contract role with the possibility (more...)
Company: Talenthub WorldWide, Inc.
Location: New York
Posted on: 08/20/2019

Business Development Manager
Description: Vessel Technologies, Inc. is a newly-formed manufacturer of modular apartment buildings, designed to provide a technological solution to the global affordable
Company: Vessel Technologies, Inc.
Location: New York
Posted on: 08/20/2019

Associate District Manager - HRO Solutions, TotalSource
Description: ADP is hiring a Sales Representative, Human Resources Outsourcing HRO - TotalSource.Thanks for clicking Let us tell you a little more... ul li Are you motivated by always progressing and achieving (more...)
Company: ADP
Location: Parsippany
Posted on: 08/20/2019

VP, Portfolio Manager / Trader
Description: The VP, Portfolio Manager x2F Trader will be responsible for maintaining and implementing the Core Fixed Income investment strategy across Assurant's 14 billion investment portfolio. br br Responsibilities (more...)
Company: Assurant
Location: Rockville Centre
Posted on: 08/20/2019

VP - Account Manager
Description: McVeigh Global Meetings and Events is a unique blending of corresponding services venue sourcing, logistics, association management, sponsorship sales, audio/visual, production and
Company: McVeigh Global Meetings and Events
Location: New York
Posted on: 08/20/2019

Customer Success Manager, Vietnam
Description: Payoneer's mission is to empower businesses to go beyond --- beyond borders, limits and expectations. In today's digital world, Payoneer enables any business of any size from anywhere to access new economic (more...)
Company: VIOLA
Location: New York
Posted on: 08/20/2019

Director Of Youth Ministry
Description: The above organization is looking for an energetic and spirited Christian individual to assist with its Youth Ministry initiative of outreach to the Community and Church. The following
Company: Heavenly Temple Church / Community Outreach Team,
Location: Bayonne
Posted on: 08/20/2019

Log In or Create An Account

Get the latest Pennsylvania jobs by following @recnetPA on Twitter!

Allentown RSS job feeds