KANKAKEE, IL, US
119 days ago
UTILIZATION REVIEW NURSE-ED
We Are Hiring!

At Riverside, everyday brings new and exciting challenges. You can expect an interesting environment where you’re part of making sure our organization is running optimally and safely, helping keep the community healthy. We provide the kind of paid training and opportunities that long-term careers are built on and we recognize hard workers who strive to make a difference. You will be able to succeed in our close-knit, safety-focused culture working together as a team. The careers we offer are meaningful because the work we do matters. Join us!


FTE: 0.010000

Shift: Varies

Location: RIVERSIDE MEDICAL CENTER

 

Summary:

The Utilization Review Nurse in the Emergency Department is responsible for assuring the most appropriate level of care and status of the patients thru collaboration with the ED providers, residents, admitting physician, social worker, case manager, and nursing staff. This position also collaborates nursing leadership and other support departments to manage patient placement, throughput, and capacity.

 

Experience/Education Requirements:

Clinical preparation as a Registered NurseGraduate of an approved school of nursing, BSN preferred. As of 1/1/18, must complete BSN within 4 years of hire or transfer.Minimum of 3-5 years of acute care experienceBi-lingual is an assetExcellent interpersonal communication and negotiation skillsAble to easily adjust to the rigorous demands of the Emergency Department

License or Certification Requirements:

Current Illinois RN license.

 

 

Responsibilities:
Alert the inpatient case managers to high risk/challenging patients being admitted through the ED.Assess/screen all potential admissions for medical necessity and level of care needs and makes recommendation to assign accurate status of inpatient or observation status.Screens patients for social work, home care and continuing needs.Maintains records documenting productivity and outcomes of interventions.May provide pre-admission/initial/concurrent review to regulatory agencies and contracted insurers.Provide information on a consistent basis to the Emergency Department staff/physicians and hospitalist admitting physicians on InterQual and/or Milliman criteria for admission, Medicare and Medicaid rules and regulations, severity of illness and intensity of service indicators, and federal, state or accrediting agency initiatives regarding safety and quality measures.
Refers patients to the ED social worker when patient does not qualify for acute level of care but needs a safe discharge from the ED.
Using preliminary diagnosis, makes recommendations for documentation to support physicians determination of Severity of illness and treatment plan.Actively participates in organizational improvement processes including committees impacting patient placement and throughput. 

Performs miscellaneous job related duties as requested. 

Proactively facilitates throughput of all patients by monitoring for census peaks including surgical and procedural patient placement.

Proactively facilitates throughput of all patients in observation status by collaborating with nursing and physicians assigned to the patient care team.

Proactively facilitates throughput of all patients by working with nursing units and leaders to identify best available bed placement at the time of request, given patient needs, staffing resources, level of care requirements, infection control and throughput goals.

 

 

 

Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.

Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.

 

Other information:

Exposure/Sensory Requirements

 

Exposure to:
Chemicals: Low risk
Video Display Terminals: Average
Blood and Body Fluids: Low risk
TB or Airborne Pathogens: Low risk.

Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Required to communicate with physicians, hospital staff, and outside agencies.
Vision: Needed to perform chart review data, computer screen work, reading data and information.
Smell: NA
Hearing: Needed for telephone communication.
Touch: Needed to write, computer entry, individual pages of chart for review.

 

Activity/Lifting Requirements

 

Average Hours per Week: 36

Shift: Days

Percentage of time during the normal workday the employee is required to:
Sit: 70%
Twist: 2%
Stand: 10%
Crawl: 0%
Walk: 9%
Kneel: 1%
Lift: 4%
Drive: 0%
Squat: 1%
Climb: 0%
Bend: 2%
Reach above shoulders: 1%

The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Continuously
Up to 20 lbs: Continuously
Up to 35 lbs: Frequently
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Lifting charts, notebook, notebook computers, office supplies. Carrying review books and notebook computers from department to nursing units. Charts carried from Medical Records to department. Handling files in file cabinet. Lifting manuals and reference information.

Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 120
Twist: 1
Stand: 30
Crawl: 0
Walk: 10
Kneel: 1
Lift: 5
Drive: 0
Squat: 1
Climb: 0
Bend: 2
Reach above shoulders: 1

Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight: 80%
Pushing & pulling Normal weight: 4x/wk
Fine Manipulation: Computer entry, writing.

Repetitive use of foot or feet in operating machine control: None

 

Environmental Factors & Special Hazards

 

Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0

Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere: Odors, Dust

Special Hazards: NA
Protective Clothing Required: None

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