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RN UTILIZATION REVIEW

Froedtert Memorial Lutheran Hospital
Full-time
On-site
Milwaukee, Wisconsin, United States

Utilization Management Nurse

Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility. This job is remote.

Standard Hours: 35.00 Shift: Shift 1 Shift Details: 7/70 schedule (7 days on, 7 days off) Weekends and holidays as scheduled.

Job Summary: Assumes responsibility for assessing a patient's clinical status on admission and daily to determine the appropriate admission status type and level of care. Refers cases to the physician advisor, PA moonlighter, for a second level review as needed. Facilitates communication with service based multidisciplinary team as it relates to the patient and identified treatment plan. Works in accordance to established policies and procedures to ensure optimal patient outcomes. Has the ability to work with variable service lines and with multiple care teams.

Experience Description: Minimum of 3 years of acute care nursing experience is required; prior utilization management or case management experience is required. A minimum of 5 years of acute care nursing experience is preferred. Utilization of Interqual, MCG care web QI or Indicia evidence based guidelines is strongly preferred.

Education Description: Professional knowledge of nursing theory and practice at a level normally acquired through completion of a program at an accredited School of Nursing is required. Bachelor's Degree in Nursing is preferred.

Special Skills Description: Knowledge of Medicare inpatient only surgical list, Medicare guidelines for admission, working DRG, and some familiarity with hospital coding is preferred.

Licensure Description: Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact). MCG certification is required within 18 months of hire. Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification preferred.

Compensation, Benefits & Perks at Froedtert Health: Pay is expected to be between: (expressed as hourly) $34.00 - $52.70. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process. Froedtert Health offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following: Paid time off, growth opportunity- career pathways & career tuition assistance, CEU opportunities, academic partnership with the Medical College of Wisconsin, referral bonuses, retirement plan - 403b, medical, dental, vision, life insurance, short & long term disability, free workplace clinics, employee assistance programs, adoption assistance, healthy contributions, care@work, moving assistance, discounts on gym memberships, travel and other work life benefits available.

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