Providence Health & Services RN Care Coordinator Utilization Management in Everett, Washington

Description:

Providence is calling a Registered Nurse (RN) Care Coordinator to the Utilization Management team. This is a Part Time/ DAY Shift (1.0) position supporting Providence Health & Services in Everett, WA.

In this position you will:

  • Oversee utilization management and review of patients care delivery while in the hospital

  • Utilize review processes for payers using medical review criteria

  • Understand of Discharge planning processes

  • Knowledge of Medicare and Medicaid rules

  • Provide insurance payer rules

  • Clinical application of anatomy & physiology

  • Knowledge regarding Best Practices & Quality standards for delivery of medical and surgical care

  • Provide education and leadership to physicians, nurses, discharge planners and utilization review specialists on a variety of issues around utilization and quality of care

  • Maintain patient and employer confidentiality

Qualifications:

Required qualifications for this position include:

  • Bachelor’s of Science Degree in Nursing (BSN)

  • Experience as an RN in a acute care setting within the last 5 years or recent Utilization Management experience

  • Current Registered Nurse (RN) license in Washington State

Preferred qualifications for this position include:

  • Utilization review or case management experience

  • Experience with Interqual or Milliman Criteria

  • Care Management, medical insurance or discharge planning

  • UM Certification

  • Case Management Certification

About the hospital you will serve.

Providence Regional Medical Center Everett in Everett, WA is the state’s most award-winning hospital for medical care; having received the HealthGrades Distinguished Hospital Award for Clinical Excellence four years in a row. Our new state-of-the-art 12 story hospital tower and the implementation of an electronic medical records system will significantly enhance our patient’s experience throughout the continuum of care.

The hospital is located in Snohomish County on the Sound and close to the mountains, so outdoor activities such as snow skiing, kayaking, and golfing are at your doorstep. The communities in Snohomish have all the comforts and appeal of small towns, with historical districts, beautiful homes, interesting boutiques, and unique restaurants, yet the city life of Seattle and Bellevue are just 30 minutes south, while the cosmopolitan city of Vancouver, BC lies only 2 hours north.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Case Management

Location: Washington-Everett

Req ID: 188795