Utilization Review Services RN PRN Position Available In Davidson, Tennessee

Utilization Review Services

RN PRN PDU

Other Nashville, TN Job Details PRN | Per diem 5 hours ago Benefits Employee stock purchase plan Disability insurance Health insurance Dental insurance Flexible spending account Tuition reimbursement Paid time off Adoption assistance Family leave Vision insurance 401(k) matching Pet insurance Qualifications Nursing Utilization review RN License Mid-level Case management SharePoint 1 year Associate’s degree Communication skills Nursing Full Job Description Introduction Do you have the PRN career opportunities as a Utilization Review Services RN PRN you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nation’s leading provider of healthcare services, HCA Healthcare. Benefits Parollon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Fertility and family building benefits through Progyny Free counseling services and resources for emotional, physical and financial wellbeing Family support, including adoption assistance, child and elder care resources and consumer discounts 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan Retirement readiness and rollover services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Learn more about

Employee Benefits Note:

Eligibility for benefits may vary by location. Our teams are a committed, caring group of colleagues. Do you want to work as a Utilization Review Services RN PRN where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise! Job Summary and Qualifications This position will focus on initial and continued to stay utilization review as needed for authorization procurement and mitigation of concurrent denials. This involves assessing the medical record for appropriateness and level of care provided, including assessment of treatment modalities, medications, services, and application of treatment protocols. Remain current with HCA education standards and guidelines, such as annual InterQual education, ongoing Midas education, and Midas worklist rules. Maintain nursing licensure for assigned geographical market and productivity. What you will do in this role: Conduct medical record review, validate admission status order, conduct a medical necessity review and provide clinical information to the payor Document all efforts to gain authorization and payor communications, confirming all days authorized or denied and document in Midas Utilize critical thinking skills to review and apply medical necessity criteria • Proficient in the application and use of InterQual Analyze documentation of clinical care from the electronic medical record Exhibit determined and assertive verbal and written communication skills when interacting with payors Demonstrate knowledge and effective use of multiple applications, systems, and resources Example, but not limited to: Call Recording, WebEx Teams, Electronic Health Records, Payor portals, Right Fax, SharePoint sites and Onbase Communicate with physicians regarding patient status, clinical documentation, and concurrent denial mitigation strategies Practice adherence to HCA UR guidelines and practice standards Ability to work independently, show initiative, and work with minimal supervision in a work-from home environment What qualifications you will need: Associates degree in Nursing required 1+ year(s) of experience in InterQual required Strong clinical background with 2-4 years of nursing experience required 1 – 3 years of relevant case management/utilization review experience preferred Registered Nurse – Currently licensed as a registered professional nurse in the state in which he or she resides and practices, in accordance with law and regulation required Multi-state nursing licensure for compact states required “Bricks and mortar do not make a hospital. People do.”- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Utilization Review Services RN PRN opening. We review all applications. Qualified candidates will be contacted for interviews. Unlock the possibilities and apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status