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Job ID: NUR00R78
Location: Hillsborough, NC
Facility/Division: UNC MEDICAL CENTER HILLSBOROUGH
Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. Actively participates in daily unit-based patient progression rounds with the care team. Responsibility will include utilization management coverage of UNC Hillsborough Hospital and Chatham Hospital.
Hours: Saturday and Sunday and some evenings
Responsibilities include: To complete admission, continued stay, and discharge reviews in accordance with federal regulations and the Hospitals' Utilization Management Plan. To ensure revenue protection by reconciling physician orders, Patient Class, and medical necessity. This may include delivering notifications to patients directly and active participation in medical necessity reviews.
Graduation from a state-accredited school of professional nursing or other professional degree with appropriate clinical and/or project management experience. If hired after October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a Bachelor's degree with a major in Nursing or a Master's degree with a major in Nursing within seven years of employment date.
Licensed to practice as a Registered Nurse in the state of North Carolina. Two (2) years of clinical experience in a medical facility and/or comparable Utilization Management experience.
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.