Top 13 Utilization review nurse Jobs in Franklin, Nh

Inpatient Registered Nurse Care Manager
Concord Hospital —Laconia, NH
- Full-time
- Nursing
- RN License
- Hospital
Registered Nurse Care Manager | Per Diem
Concord Hospital —Concord, NH
- Part-time
- Nursing
- RN License
- Hospital
Registered Nurse - Unit Manager
Aarna Technologies LLC —Franklin, NH
- $63 - $67 an hour
- Contract
- Experience working with individuals with developmental disabilities
- Nursing
- Anatomy knowledge
- Health insurance
- Referral program
Quick Apply
7d
Nursing Supervisor
Huggins Hospital —Wolfeboro, NH
- Part-time
- Nursing
- RN License
- Hospital
3d
NURSE
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Plymouth, NH
- $29.91 - $48.61 an hour
- Full-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
Registered Nurse - Unit Manager
M/S CLOUDSPACE IT SOLUTIONS —Concord, NH
- $62 - $66 an hour
- Urgently hiring
- RN License
- BLS Certification
- Physical & Rehabilitation Medicine
- Opportunities for advancement
- Referral program
Quick Apply
10d
Clinical Appeals & Grievances Nurse Reviewer
Tanaq Support Services LLC —United States
- Weekends as needed
- Microsoft Word
- Nursing
- Microsoft Excel
Appeals Professional III (Licensed Clinician)
Tanaq Support Services LLC —United States
- Full-time
- Remote
- Nursing
- RN License
- Writing skills
9d

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Inpatient Registered Nurse Care Manager

Concord Hospital -
Laconia, NH

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Job Details

Full-time

Qualifications

Inpatient experience
Utilization review
RN License
Acute care facility experience
Associate's degree
Associate Degree in Nursing

Full Job Description

Summary

The Inpatient Nurse Care Manager, in collaboration with the multidisciplinary team is responsible for assessing, planning, implementing, and evaluating patients, incorporating the clinical, psychosocial, and family factors specific to the care and disease management plan. Communicates and manages the transitions of care and assists patient and family to navigate the health care systems. Recognize and intervene to secure resources necessary for the care and safety of the patient and family across the continuum of care. The Inpatient Care Manager will recognize and intervene to secure resources necessary through collaboration with financial payers/insurers for the care and safety of the patient and family across the continuum of care.

Education

Associate's degree in nursing from an accredited nursing program. Bachelor's degree in nursing preferred.

Certification, Registration & Licensure

Licensure required: Current NH RN License.

Experience

Acute Care Facility experience of 2 years in a clinical specialty or Care Management, Discharge planning, Quality Improvement and Utilization Review. Demonstrates effective interpersonal, organizational and motivational skills. Demonstrates ability to function as a team player. Proficient in written and verbal communication.

Schedule

Monday through Friday

40 hours a week

Responsibilities

Provides assessment and evaluation of patient for clinical, psychological and social factors that may contribute to their disease process and may require specific or complex continuing care needs and supportive services. Provides an initial review and concurrent reviews as required for each patient for clinical, psychological and social factors that may contribute to the disease process for determination of appropriateness of status, severity of illness and intensity of treatment. Review of admission history and document in EMR.
Interfaces with patient, physicians, nurses, social workers, other hospital departments, community based facilities, services and financial institutions as necessary, to affect changes in the management of cases, monitoring delivery of services and/or to secure the necessary resources. Provides information to third party payers with required documentation of medical necessity.
Provides support to the patient and families and provides evaluation and coordination with care planning and patient safety while arranging for transitional care and discharge planning needs. Through utilization review determines if patient is meeting criteria of evidence-based clinical guidelines for appropriate level of care. Identifies the need to execute the appropriate letter when medical necessity is not met and issue letters of patient liability regarding the hospital admission.
Bases care management and utilization review actions by applying principles of purposeful, organized thinking to make sound clinical judgment/decisions.
Documents measurement and evaluation of financial, clinical, functional and satisfaction outcomes as patient progresses towards desired goals.
Evaluates and responds to the learning needs of clients, clinicians and community regarding discharge planning and utilization review.
Manages the care and utilization review of simple to complex multi-system patients by using time and resources efficiently.
Provides leadership to members of the health care team relative to discharge and care planning.
Performs other duties as assigned.

Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, sexual orientation, gender, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.

Know Your Rights: Workplace Discrimination is Illegal

Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, you may contact Human Resources at 603-230-7269.

Physical and Work Requirements

The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The Dictionary of Occupational Titles Material Handling Classification is LIGHT. The employee must regularly lift, carry or push/pull less than 10 pounds, frequently lift, carry or push/pull up to 10 pounds, and occasionally lift, carry or push/pull up to 20 pounds.

While performing the duties of this job, the employee is regularly required to speak. The employee is frequently required to bend, do fine motor, do repetitive motion, hear, kneel, reach, sit, squat, stand, and walk.

Specific vision abilities required by this job include color vision, depth perception, far vision, near vision, and peripheral vision.

The employee is occasionally exposed to airborne contaminants, airborne pathogens, bloodborne pathogens, bodily fluids, and electrical hazards - shock.

The noise level in the work environment is usually moderate.

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utilization review nurse jobs in franklin, nh

Inpatient Registered Nurse Care Manager

Registered Nurse Care Manager | Per Diem

Registered Nurse - Unit Manager

Nursing Supervisor

NURSE

Registered Nurse - Unit Manager

Clinical Appeals & Grievances Nurse Reviewer

Appeals Professional III (Licensed Clinician)

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