We are Hiring at Jewish Hospital
Location: 530 S Jackson St, Louisville, KY 40202
Shift Options: Full Time, First
About Us
UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital.
Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 14,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to www.UofLHealth.org.
Our Mission
As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.
Under the direction of the Director, Care Coordination, the Utilization Review RN performs activities which support the Utilization Management functions. The Utilization Review RN is responsible for the delivery of the Utilization Management process not limited to and including: making clinical recommendations regarding medical necessity for admission and continues stay, screens patients for client specific guidelines regarding insurance, Medicare and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews. Communicates with physician and case managers regarding payor approval/denial of admission and continues stay review. Process payor denials and retro reviews. Promotes optimal health care outcomes in accordance with the policies, procedures, applicable laws and contracts, philosophy, mission and values of the University of Louisville Hospital; assumes responsibility and accountability for the appropriate utilization of facilities and services; serves as a resource to physicians; conducts admission and concurrent reviews including observation and inpatients; identifies patients who do not meet criteria and takes action to ensure patients are cared for in the most appropriate level of care; coordinates care in conjunction with other members of the interdisciplinary healthcare team to provide and facilitate optimal health and financial accountability. Utilizes the nursing process (assess, plan, implement and evaluate) and management process (plan, organize, direct and control) to provide a framework for decision-making; maintains confidentiality of information; actively supports organizational goals and objectives by providing needed information to divisions and departments.
Required Qualifications
Preferred Qualifications
Benefits & Perks
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