Registered Nurse (RN) - Behavioral Health Utilization Review

Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note: Eligibility for benefits may vary by location and is determined by employment status Job Summary Job Type: Per Diem Job Shift: Rotate Holiday Rotation Department: Behavioral Health Position Summary Reporting to the Director of Case Management, the Utilization Review Nurse is responsible for ensuring that patients being admitted to Doctors Behavioral Health Center are admitted to the appropriate level of care in accordance with the vision and goals of Doctors Medical Center and the regulatory guidelines as set by the state and federal rules. The Utilization Review Nurse ensures quality, cost-effective patient care through planning; communication, critical thinking and facilitation of the multi-disciplinary patient care team. Coordinates Utilization Review activities to ensure that authorizations are obtained for in-patient acute hospitalizations. Acts as a liaison between MD’s, the Treatment Team and External Review Organizations. Reviews the Treatment Plan and monitors the delivery of care to make sure the desired treatment outcomes are achieved.. Communicates reimbursement issues, trends and patterns to the Director of Case Management and the Administrator. Qualifications Minimum Education: BSN preferred. Minimum Experience/Skills One or more year’s recent acute hospital experience Minimum of one year acute, inpatient psychiatric or chemical dependency experience. Good communication, documentation and organizational skills. Self motivated and able to function with a minimum of supervision. Demonstrates personal maturity, independent judgment and integrity. License/Certificates/Credentials Current CA Registered Nurse License Current BLS certification Organization Description Doctors Medical Center (DMC), part of the Central Valley Doctors Health System, is the largest full-care hospital between Stockton and Fresno, and from the Sierras to the San Francisco Bay Area, with a 394-bed general acute care and a 67-bed inpatient psychiatric capacity. DMC is known for providing comprehensive inpatient, outpatient and emergency care. Doctors Medical Center offers a wide range of services including cardiology, neurosurgery, orthopedics, emergency and trauma services, minimally-invasive and robotic surgery, women and childrens services, medical/surgical, behavioral health, oncology and critical/intensive care. Join our team! Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: http://www.uscis.gov/e-verify( opens in new window)( opens in new window) The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. 2603017180 Salary: $68.70 - $105.41 hourly **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience Show more Show less