Registered Nurse (RN) - Manager
Saint Francis Health System
Tulsa, OK
$33+/hourOverview
- Start DateASAP
Pay
Benefits
- Holiday Pay
- Continuing Education
- 401k retirement plan
- Wellness and fitness programs
- Employee assistance programs
- Medical benefits
- Vision benefits
- Dental benefits
Description
Current Saint Francis Employees - Please click HERE to login and apply.
Full Time3p - 11pHours: Monday - Friday | 3:00pm - 11:00pm
Job Summary: Provides administrative and clinical support to the hospital and treatment teams throughout the review of patients including, but not limited to their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details of reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to the improvement of internal processes.
Minimum Education: Has completed the basic professional curricula of a school of nursing as approved and verified by a state board of nursing, and holds or is entitled to hold a diploma or degree therefrom or Master's degree in Nursing.
Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License.
Work Experience: Minimum 3 years of related experience in an acute care setting.
Knowledge, Skills and Abilities: Ability to organize and prioritize work in an effective and efficient manner. Effective interpersonal, written, and oral communication skills. Demonstrated ability to integrate the analysis of data to discover facts or develop knowledge, concepts, or interpretations. Ability to be detail oriented as required in the examination of numerical data. Ability to synthesize clinical case data into concise summaries. Working knowledge of Microsoft Word, Excel and Access in the preparation of correspondence and reports.
Essential Functions and Responsibilities: Gathers, prepares and supplies required clinical/treatment information needed to obtain authorization within the review interval(s) time requirements. Participates in treatment team and/or Patient Care Committee by providing information about eligibility, benefits, and criteria for the selected level of care. Assists in discharge planning, as needed. Identifies QI Triggers for individual patient situations, reporting them promptly to the UM Manager, appropriate clinicians and Process Improvement/Quality Director. Reviews eligibility and benefits of patients to validate accurate level of care utilization. Investigates and prepares appeals for insurance companies when denial of reimbursement is related to medical necessity or to other treatment issues. Participates in quality-of-care and UM process improvement on an ongoing basis and assists with development of the UR Staff Committee's process improvement goals. Provides staff education to further the goals of UR.
Decision Making: The carrying out of non-routine procedures under constantly changing conditions, in conformance with general instructions from supervisor.
Working Relationship: Works directly with patients and/or customers. Works with internal customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above.
Special Job Dimensions: None.
Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.
Utilization Review Management - Yale CampusLocation:
Tulsa, Oklahoma 74136EOE Protected Veterans/Disability
Employer
Saint Francis Health System
About Tulsa, OK
- Tulsa's cost of living is 16% lower than the national average, making it an affordable place to live.
- Wages generally match up with the lower cost of living, providing a good balance for residents.
- Summer average highs are around 92°F, and winter average lows are around 26°F, offering a mix of seasons for those who enjoy variety.
- Short term rentals are relatively easy to find in Tulsa, with various options available for travel nurses.
- Tulsa is car-friendly with easy access to major highways.
- Public transportation options are available but may not be as extensive as in larger cities.
- Tulsa has a diverse population with a wide age range.
- Common health issues may include obesity and related conditions.
- There is a growing population of travel nurses due to the presence of several healthcare facilities.
- Tulsa offers a variety of activities including dining at local restaurants, exploring art and music at museums, enjoying outdoor activities at parks, and engaging in sports such as golf.
- The city has a vibrant cultural scene with something for everyone.
Browse similar jobs
Registered Nurse (RN) - Manager
- Saint Francis Health System
- Tulsa, OK
Registered Nurse (RN) - Manager
- Saint Francis Health System
- Tulsa, OK
Registered Nurse (RN) - Manager, ED - Emergency Department
- INTEGRIS Health Baptist Medical Center
- Oklahoma City, OK