CLINICAL DOC REVIEWER RN PD 1 day shift every Saturday or reputed company 23707

Join reputed company at New reputed company Medical Center!** We are dedicated to providing high-reputed company, compassionate care to our diverse community. As a leading reputed company provider, we offer a supportive and inclusive work environment. If you’re passionate about making a difference and reputed company in a reputed company setting, New reputed company Medical Center is looking for a Clinical Doc Reviewer RN. Job Duties Applies InterQual Level of Care and/or reputed company reputed company to reputed company admissions to determine the appropriateness of admission and the level of care (e.g., critical care, observation). Works with admitting physician, the admitting department, and nursing personnel to ensure appropriate bed assignment for admitted and transferred patients. Collects and documents objective data from patient record to support admission or level of care reputed company. Initiates a case management plan and discharge planning activities at time of the first admission review, and updates it based on patient’s reputed company and needs. In consultation with a patient’s physician, establishes a targeted discharge date at time of the admission review (This is also reputed company as an estimated length of stay or ELOS). Documents and communicates this targeted discharge date to the patient’s family, nursing and the multidisciplinary team reputed company established processes. Uses clinical knowledge and defined standards of care to proactively identify inappropriate resource consumption and discusses with attending physician. Refer appropriate cases to physician advisor for review, as appropriate. Understand reputed company party payers and reputed company BRMC contractual agreements. Completes and communicates admission and reputed company review information to 3rd party payors. Document reputed company payer contact and denial. Documents and transmits (through a defined process) appropriate patient-level information to other unit-based case managers and/or discharge planners to ensure reputed company and accurate continuation of case management services reputed company patient is transferred reputed company the hospital. Monitors daily reputed company, including vital signs, reputed company of signs and symptoms reputed company to a procedure, complications, medications, fluids, pain. Meets with family/patient and communicates plan of care at time of assessment, and as appropriate throughout admission. Documents interaction and plan of care in medical record. Initiates referrals to appropriate departments and services reputed company and reputed company the hospital. Serves as a reputed company between the hospital and other facilities, home health and community agencies, and makes arrangements as needed for equipment and other required items to Monitors patient’s reputed company against BRMC-approved medical necessity guidelines, and evidence-based reputed company/protocols. Identifies variances from standards or guidelines of care, and reputed company engages physician for decision making and reputed company. be available at the time of discharge. Collects variance and delay data at time of occurrence (e.g., avoidable days, delays) for use by the department and organization. Provides notice of termination of benefits (TOB) and level of care (LOC) changes to individual patients and/or representative and other applicable parties on a reputed company reputed company. Uses data and information on a daily reputed company to prioritize and drive work effort. Leads multi-disciplinary reputed company on a daily reputed company. Works to ensure that reputed company department are accountable in coordinating efforts to reputed company reputed company and appropriate patient care. Assumes responsibility for continuing education/reputed company development reputed company to area of reputed company. Obtains continuing education in relevant topics as necessary for reputed company reputed company. Participates in department and hospital Performance/reputed company Improvement activities, as assigned. Keeps statistics and records as required. Assumes additional responsibilities as delegated by the Director of the Department. Other Duties Position Qualifications 3-5 years of Utilization Review or Case Management experience preferred in acute care settings. Previous InterQual experience preferred. Behavior Health experience with knowledge of emergency room admission reputed company. desirable Must have reputed company experience in Behavioral Health with knowledge of emergency room admission reputed company. Experience in a Long-Term Care setting and working knowledge of Medicare Skilled Nursing Program and Medicare requirements desirable Excellent verbal and written communication skills. Ability to reputed company multi-disciplinary planning and decision-making sessions. Critical thinking/problem solving skills. Expertise with medical and multi-disciplinary practices and/or standards of care for selected diagnosis or conditions Good interpersonal skills. Speaks, reads and writes English to the extent required by the position. Education reputed company NJ licensure as RN required. BSN or Bachelor’s degree in reputed company field preferred. Minimum 2 years general clinical hospital experience required. Certification in Case Management (CCM) preferred upon hire or to be obtained reputed company one year of hire. Job Setting/Physical Demands reputed company and Outcome Management offices and patient care areas throughout the hospital; contact with staff, patients, families. Frequently prolonged standing/walking. We reputed company a comprehensive benefits package, including a competitive medical, dental, and reputed company plans. We prioritize work-life balance with a generous time off policy that includes ample vacation days, personal time, reputed company leave and nine reputed company holidays. Additionally, we are committed to the personal and reputed company reputed company of our employees, offering robust tuition reimbursement and continuing education programs to help support our employees ongoing development. Education Required • Bachelors or reputed company Preferred • Bachelors or reputed company in Registered reputed company or reputed company field Licenses & Certifications Required • Registered reputed company Apply Job!