Staff Position

Registered Nurse (RN) - Utilization Review
Kaiser Permanente Central Hospital Capitol Hill Campus
Washington, DC
days
Sign-On Bonus

$30-48/hour
From the web

Description

Utilization Review RN - Discharge Planning, Short Hours, Washington Hospital Center - Washington, DC


 


Job Summary:


The Utilization Review RN is responsible for utilization review, discharge planning and transitions in care, in collaboration with MAPMG rounder in acute or alternative settings of care.





Essential Responsibilities:



  • Utilization Review. According to department policy, procedure and protocols, consistently apply and verbally communicate approved utilization review criteria and guidelines for services delivered in acute or alternative care settings.

  • Eligibility and Benefit Verification. Confirm eligibility status and ensure the appropriate administration of benefits in accordance with department policies and procedures.

  • Assessing Right Venue of Care with Hospitalist. Collaboration with Hospitalist to assess the appropriate level of care for patients (i.e., Medical Unit, Surgical Unit, Tele Unit, TCU, ICU) and post- (Home, Continuum or Community-based Services) hospitalization.

  • Coordination of Care. Driving patient care plan through assuring daily plan is executed, and management of transitions and post-hospital care.

  • Effective Discharge Planning. Prompt, clinically appropriate discharge planning beginning at time of admission.

  • Variance Management. Timely steps in identification of delays in throughput, escalation to correct delays, and recording delays to identify patterns and trends that will require corrective actions.

  • Quality Screening. Demonstrate competency to assess all aspects of care across the continuum for variations from quality and utilization standards.

  • Performs other related duties as directed.


 


Case Management experience preferred.  May be required to float to CNMC to backfill for call outs and vacation. Every other weekend (Saturday/Sunday).


 


Basic Qualifications:


Experience



  • Minimum one (1) year of experience as an RN in an acute care setting.



Education



  • N/A



License, Certification, Registration



  • This job requires credentials from multiple states. Credentials from the primary work state are required before hire. Additional Credentials from the secondary work state(s) are required post hire.




  • Registered Nurse License (Maryland) within 6 months of hire AND Registered Nurse License (Virginia) within 6 months of hire



      OR




  • Compact License: Registered Nurse within 6 months of hire




  • Registered Nurse License (District of Columbia) within 6 months of hire




  • Basic Life Support



 


Additional Requirements:



  • Annually: Successful completion of PCC Assessment of Critical Skills. Passing score on inter-rater reliability.

  • Ability to effectively communicate.

  • Ability to conform to established policies and procedures.

  • Ability to analytically problem solve and make decisions.

  • Ability to tolerate and cope with ambiguity

  • Ability to work as a team member.

  • Proficiency in the use of applicable computer software.

  • Demonstrated ability to effectively and clearly present information through the written word, to influence or persuade others through oral presentation in positive or negative circumstances, and to listen well.

  • Demonstrated ability to write clearly, legibly, and effectively, to present ideas and document activities, to read and interpret written information.



 


Preferred Qualifications:



  • Recent acute care, case management, or home health experience preferred.

  • B.S.N. preferred.


Pay

Average District of Columbia Staff Position Pay

$44.14/hour

The average salary for a Utilization Review is 2% lower than the US average of $45.

Estimate based on Bureau of Labor Statistics data.