RN - Care Coordinator - In-Patient - Utilization Review

Pay Range:

Pay Range:$41.66 - $58.69

$25K Sign On and $10K Relocation for qualified hire!

As part of a consortium-wide team, support and manage patient progression of care in the hospital setting, promote evidence-based protocols, ensure the appropriateness of interventions, assess patient psycho-social needs, and expedite care delivery for patients.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Key Essential Functions and Accountabilities of the Job

• Works collaboratively with consortium wide team supporting inpatient Care Coordination and Utilization Management

• Coordinate local CAH Swing Bed/Transitional Care program.

• Lead local CAH Inpatient interdisciplinary team meeting.

• Reviews all admissions to develop personalized treatment plans that are clinically appropriate, match the patients care needs and are consistent with patient choice and available resources while ensuring a timely and appropriate discharge.

• Collaborate with providers, leadership, and clinical support team to ensure treatment plan is based upon patient need and meets criteria approved by consortium and regulatory agencies/payors.

• Ensure ongoing documentation supports Utilization Management functions and communicate with payors appropriately.

• Provide appropriate information to educate patients/families regarding healthcare benefits and treatment plan.

• Assess patient to obtain relevant psycho-social information, make interventions and professional support referrals as needed.

• Develop and communicate discharge plan with the care team and patient/family, ensuring safe and well-coordinated transition of care.

• Support Peer Review process as part of consortium plan.

Education, Certifications, and Licenses Required

• Current full, unrestricted Registered Nursing license in Alaska or other U.S. state required. Bachelor's preferred.

• Direct Hire must have applied for an Alaska nursing license before start date.

• Agency staff must have an active Alaska license.

• Case Management certification by recognized certifying organization within 24 months of hire.

• BLS.

• ACLS.

• PALS preferred.

• High school diploma or equivalent required.

• Clinical Competency required within 3 months of hire and every three years

• High Risk Competency required within 3 months of hire and every year

Experience Required

• 5 years clinical nursing experience

• 1 year experience with chart review, risk management, or related quality service preferred.

Knowledge of

• Medical record review, medical necessity/insurance guidelines, and regulatory compliance.

Skills in

• Communication, both verbal and written

• Strong organizational skills

Ability to

• Work collaboratively as part of an interdisciplinary team.

• Build relationships with colleagues, community partners, and consumers.

Physical Demands:

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms.

• The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. The employee must lift and/or move 50 lbs.

Required Certifications:

Advanced Cardiovascular Life Support (ACLS)- American Heart Association, Basic Life Support (BLS)- American Heart Association, Case Manager Certification- Commission for Case Manager Certification, Clinical Competency Assessment- SEARHC, High Risk Competency- SEARHC, Registered Nurse License- State of Alaska- Alaska State Board of Nursing

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!