Jul 22, 2021

Utilization Management Nurse Relief - Case Management

  • Providence
  • Seattle, WA, USA

Job Description

Description:

Swedish Medical Center is looking for a Utilization Management Nurse Relief (PER DIEM, DAY SHIFT) to work for the Case Management Department at Swedish Shared Services in Seattle, WA.

The Utilization Management Nurse Relief encompasses a broad knowledge of health care delivery that includes but is not limited to managed care regulations, contract terms/stipulations, utilization review and governmental agency regulations.

In this position you will:

  • Collaborates and consults with appropriate departments and providers as needed to determine that medical necessity indicators are met
  • Provides a clinical review of the medical record to determine an admission status type of a patient
  • Conducts concurrent clinical reviews to assess ongoing medical necessity
  • Identifies, reports cases and problems appropriate for secondary review to Case Management leadership, the Medical Director or Physician Advisor
  • Facilitates appropriate provider documentation to accurately reflect patient severity of illness and risk

Qualifications:

Required qualifications for this position include:

  • Nursing Baccalaureate degree (BSN) from an accredited school of nursing
  • Current license to practice as a Registered Nurse in the State of Washington
  • Three (3) years Registered nursing experience in the clinical setting

Preferred qualifications for this position include:

  • ACM or CCM certification
  • One or more years of case management experience

About Swedish Shared Services:

Swedish is the largest, most comprehensive, nonprofit health provider in the Greater Seattle area. Our expanding network of facilities currently includes three hospital locations in Seattle, a hospital in Edmonds and the new Swedish Issaquah campus. It also consists of Swedish Medical Group’s network of primary care clinics, and affiliations with suburban hospitals and specialty clinics throughout Greater Seattle.

Each campus has a local operations leadership team, supported by centrally located and led corporate services, such as Human Resources, Financial and Information Services.

We offer a full comprehensive range of benefits — see our website for details

https://caregiver.ehr.com

Our Mission

Our Mission is to improve the health and well-being of each person we serve.

Our Vision is Health for a Better World.

About Us

Swedish is the largest not-for-profit health care system in the greater Seattle area. It is comprised of five hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); emergency rooms and specialty center in Redmond (East King County) and the Mill Creek area in Everett; and Swedish Medical Group, a network of more than 128 primary care and specialty care locations throughout the greater Puget Sound area. Swedish employs nearly 13,000 caregivers (all employees), including nearly 1,400 providers. Whether through physician clinics, education, research and innovation or other outreach, we're committed to caring for the people in our region and beyond. Swedish is proud to be an Equal Opportunity Employer Swedish does not discriminate on the basis of race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: On Call

Shift: Day

Job Category: Case Management

Location: Washington-Seattle

Work Locations: Metropolitan Park East (WA152) 1730 Minor Avenue Metropolitan East Tower Seattle, 98101

Req ID: 277947