Company: Heywood Hospital
Location: Gardner, MA
Career Level: Mid-Senior Level
Industries: Recruitment Agency, Staffing, Job Board
Description
- Certification Details
- Current Massachusetts Registered Nurse License
- Job Details
- Minimum Education BSN preferred
- Minimum Work Experience Previous UR/QA experience required
- 2 years of healthcare experience within the Acute Care, SNF, HHA, Behavioral Health, and/or Insurance Industry preferred
- Proficient computer skills required
- Must have effective written, verbal and interpersonal communication skills
- Excellent critical thinking
- Ability to multitask and flexibility essential
- Discharge planning experience as it pertains to the care transitions, referral process, patient preference/choice services, patient & family satisfaction, post-discharge follow-up etc.
- Job Requirements
- Current Massachusetts Registered Nurse License
- Interqual experience or equivalent preferred
- Meditech Expanse experience preferred
- Schedule Information
- Exerts 20 to 50 pounds of force occasionally, and/or up to 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.
- Unit Specific Information
- Utilization Management- Utilization Review and Care Transitions & Coordination
- Multidisciplinary Team Rounds-participates in discharge planning rounds daily
- Quality & Statistical Data: Reviews medical record for abnormal findings, complications, delays, and deviations
- Denials/Appeal Process: Completes assessment of denial within 1 week providing supporting documentation
- Discharge Planning: Completes discharge planning assessments timely, efficiently and completely following regulatory standards
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