Providence Health & Services RN Case Manager- Utilization Review in Centralia, Washington
Providence is calling an experienced Registered Nurse Case Manager to join the Care Management team at Providence Centralia Hospital in Centralia, WA.
We are seeking a compassionate and caring RN to ensure that patients and their families receive quality, cost-effective health care.
The RN Case Manager reviews patient charts and coordinates with the insurance companies and physicians while ensuring CMS rules/regulations compliance is maintained. They also facilitate safe discharge planning for patients by coordinating transportation, locating facilities, helping patient's achieve their post-acute care goals, and assisting families with locating resources.
This is a per diem (on-call), variable shift position.
In this position you will:
Assess and monitor patients, determine eligibility for treatments and ensure the plan of care meets the patient's needs.
Perform comprehensive medical reviews utilizing appropriateness criteria and interpret implications of clinical status and medical treatment plan with current federal regulations and guidelines.
Ensure that the resource utilization, care delivery, and discharge planning are closely coordinated so as to optimize the patient's stay in the hospital.
Contribute to the clinical performance improvement by providing direction on ways to improve efficiencies, reduce costs, receive appropriate reimbursement, and meet regulatory requirements.
Required qualifications for this position include:
Graduate of an accredited school of nursing with ADN or greater
Current Registered Nurse (RN) licensure in Washington State
Minimum of 3 years experience medical – surgical (or comparable) nursing in the acute care setting. Demonstrates positive, professional and personal image.
Preferred qualifications for this position include:
- Bachelor of Science Degree in Nursing (BSN) . Minimally 1 year recent acute care experience in Quality, Utilization Review, or Case Management
About the hospital you will serve .
Providence Centralia Hospital in Centralia, Washington is a 127-bed, not-for-profit hospital providing emergency, diagnostic, cancer, birthing and surgical services. It consistently receives high scores on accreditation surveys by the Joint Commission, the Washington Department of Health (DOH) and the Washington Department of Social and Health Services (DSHS).
We offer a full comprehensive range of benefits - see our website for details
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.
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: On Call
Job Category: Case Management
Req ID: 153342