AZ - RN Case Management/Utilization Review - First Connect : Job Details

Job Description:

*******Fingerprinting must be submitted and cleared prior to start!***** **PLEASE SUBMIT CURRENT ADDRESS FOR FINGERPRINT PACKET TO BE MAILED VIA FEDERAL EXPRES** Please submit only if Tuba City housing and travel are secured. MUST provide copies of current immunizations, negative Tb skin test proof of last two years, provide documentation of 2 MMR vaccinations, Tdap, and Flu shot. Clean background check, negative 10 panel drug screen within 7 days, all PRIOR to arrival. Tuba City Regional Healthcare does not require your RN to have an AZ state license. Tuba City Regional Health Care Corporation, a JCAHO accredited health center, provides services to a 4,400 square mile area and serves as a referral center for the western part of the Navajo and Hopi Reservations. The hospital was constructed in 1975 with a bed capacity of 73. Services provided to the community include comprehensive inpatient/outpatient emergency services, dental and ophthalmology services, orthopedics, OB/GYN, oral surgery, eye surgery and urological procedures. Approximately 49% of the surgeries performed are out patient/ambulatory surgical procedures. Learn more about our organization. The Tuba City Regional Health Care Corporation is located in Northwestern Arizona on the land known as the Colorado Plateau. This semi-desert landscape varies in elevation from 4,400 in the Little Colorado River Valley to nearly 7,000 feet at Preston Mesa. The unique community of Tuba City offers a culturally rich environment. The Native American tribes located and served here are the Navajo, Hopi, and Southern Paiute. This mixture along with Anglo, Hispanic, and African American employees of the hospital and school systems make a pleasantly diverse community. The staff of medical providers includes surgeons, general medical officers, internal medicine, psychiatrists, pediatricians, family practice physicians, obstetricians, ENT specialists, orthopedic surgeons, and urologists. Dental staff includes general dentists, endodontists, oral and maxillofacial surgeons, pediatric dentists, dental assistants and hygienists. The nursing staff includes registered nurses, licensed practical nurses, nursing assistants, community health nurses, nurse practitioners, nurse midwives, CRNA, and community health medics.

POSITION SUMMARY

Incumbent serves as an Outpatient/Inpatient CaseManager/Utilization Review Registered Nurse (CM/UR RN) for TCRHCC and isresponsible for direct supervision and supportive contact for the specificgroup of identified patient assignments and high-risk patients. The CM/UR RN is responsible for designing andmanaging a continuum of care focusing on empowering clients to achievedemonstrable outcomes and self-sufficiency. The CM/UR RN is responsible for assessment, service planning, andresource acquisition, monitoring progress and initiating and responding toemerging client needs. The CM/UR RNperforms Utilization Review and Management/Clinical Documentation Chart Reviewsof patients in the acute clinical care setting, ambulatory care setting andwill conduct UR reviews as required. The CM/UR RN will work closely with theSocial Work (MSW) Case Manager on Discharge Planning and Care Transitions. The CM/URRN will work closely with the Physician Advisor and participate on the URCommittee as well as conduct Clinical Documentation Chart Reviews related topeer review, financial or insurance determination, or claims denials. The CM/URRN will link the client with Community Social Service providers, health careproviders, substance abuse, and mental health providers to achieve specificgoals. The CM/UR RN will have experienceworking with culturally diverse low-income populations having multiple barriersto self-sufficiency such as: illiteracy, welfare dependency, domestic violence,substance abuse, and mental health issues. The CM/UR RN will work with a multidisciplinary team within the servicedelivery setting. The CM/UR RN will becommitted to Case Management Services and have some collaboration withPurchased and Referred Care (PRC) formally known as Contract Health Services,providing assistance with the PRC Case Specialist. The CM/UR RN will be responsible to theDirector of Care Coordination.

NECESSARYQUALIFICATIONS

Education:

AssociatesDegree in Nursing (ADN), must obtain bachelors in nursing within two (2) yearsof hire

License/Certification:

Musthave and maintain current Basic Life Support (BLS) certification by theAmerican Heart Association (AHA) throughout employment

Avalid, current, full and unrestricted Professional Nursing License to practice asa Registered Nurse (RN) in any state of the United States of America, The Commonwealthof Puerto Rico, or a territory of the United States

Experience:

Three (3) years of clinical nursingexperience performing direct patientcare with at least 2 years in an Inpatientsetting on a medical-surgical unit, PACU,or higher acuity Inpatient unit (ICU, Step-Down, Telemetry, etc.) or homehealth (direct care) {clinical experience qualification may be determined byhiring manager/director.}

Demonstrate knowledge of the case management, purchased referred care and utilization reviewprocesses.

Demonstrateknowledge of electronic health record systems.

Position Urgency:NormalShifts:Monday to Friday, 8am-5pmWeekend on call rotation, would be 1 weekend a monthState License Details:Must Be Currently ActiveMinimum Years of Experience:3Specialty Type:ORIENTATION: Every two (2) weeks only. COVID EXEMPTIONS: We do not accept religious exemptions. If a candidate submits for a medical exemption, we will have to get approval from our medical review board to proceed with onboarding. HOUSING APPLICATION: must be submitted 2 weeks prior to start date - form uploaded in ***Sub Specialty:Care Manager, Utilization Review RNGeneral Certifications:, General Certifications(BLS/BCLS)Nursing Certifications:Contract Length in Weeks:13