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Utilization Review Nurse/Case Managers

King Of Prussia, PA

Details

Hiring Company

Universal Health Services, Inc. Website

Positions Available

Full Time


Position Description

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

UHS is hiring Utilization Review Nurse/Case Managers to join our team.

As a member of the UHS Acute Care Division Patient Admission Review Center, this role supports hospitals in making patient status determination and proper documentation of the patient’s clinical presentation and diagnosis.  Reviews the clinical data presented by the hospital and applies evidence based clinical decision support tools to identify options for level of care determinations and corresponding documentation standards.  Advises hospitals on applicable patient status criteria and documentation practices that would substantiate the status determination, with clinical decision-making and patient status determinations remaining at all times with the treating providers and hospital at which the patient is located.  Collaborates with the treating physician to ensure the patient is placed in the most appropriate status based on the clinical indications documented in the medical record. This position performs independent, criteria based, documentation assessment, via medical record review and discussion with the physician as needed, on all patients referred.

Qualifications:

  • Associates degree with a minimum of 5 years’ experience, Bachelor's degree preferred.
  • RN required, but will consider other healthcare related experience if related to patient level of care status determinations.
  • Computer proficient with strong typing skills in Microsoft applications specifically Microsoft Word and Excel.
  • Working knowledge of current evidence based clinical decision support tools with the ability to apply the criteria consistently and accurately. InterQual experience strongly required.
  • Ability to accept ownership and accountability for compliance with CMS and UHS best practice guidelines.
  • Ability to prioritize, problem solve and multi-task.
  • Proficiency in utilizing clinical software programs and electronic medical records.
  • Proficient understanding of patient care cost and reimbursement information.
  • Excellent phone and communication skills and ability to convey key concepts succinctly and clearly.
  • Positions are remote.

To learn more about Universal Health Services, or apply please visit:

https://uhs.hua.hrsmart.com/hr/ats/Posting/view/135 

EOE/Affirmative Action Employer M/F/D/V


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