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Employment Type:

Full time

Shift:

Description:

Functions as Primary Nurse Reviewer for Observation services.

• Maintains a working relationship with onsite Physician Advisor

• Educates Observation Case Managers, including week-end staff regarding appropriate process of telephonic and submission of cases

Reviews hospital admissions to ensure appropriate admission status in accordance with Indicia/InterQual criteria and to assure that the physician admits patient under the guidelines of the Managed Care Companies thus facilitating the authorizations.

• Communicates with physicians regarding appropriate setting for patient care

• Initiates clinical review in Epic and notifies PAS to start the notification process if not already completed to obtain authorization for admission.

• Faxes appropriate clinical documentation to Managed Care Plans to ensure authorization for hospital stay.

***Hybrid Position***

_Position Purpose:_** **Utilization Review (UR) Nurses play a vital role in healthcare by making sure that patients receive appropriate care while managing healthcare costs effectively. They assess patient care plans and medical records to verify the necessity and effectiveness of the treatments being proposed or provided.

_What you will do:_

*Observation and Inpatient admission criteria in accordance with Indicia/InterQual criteria, CMS, and Managed Care regulations.

*Ensure Observation services begin when care is initiated in accordance with the physician’s order for patients placed in observation, from the ED or as directed admit. This time will be identified by the time the order for Observation is written by the attending physician. Extended Recovery services begin after an ambulatory surgery patient arrives on the unit after the routine period ends

*Patients receiving Observation/Extended Recovery services will be reviewed at least daily to ensure the patient is continuing to meet Observation level of care. If the patient meets Inpatient criteria, the Nurse will obtain a physician order to change the patient’s status to inpatient. If the patient is meeting discharge criteria or is out of Observation time and not meeting Inpatient criteria, the attending physician will be contacted to secure orders for discharge

*Functions as a preceptor for case managers in the Observation Case Manager role.

*Responsible for educating and communicating Physicians regarding appropriate

*Assumes responsibility for work queues as assigned to the Department.

*Demonstrates good operational management and facilitation skills.

_Minimum Qualifications:_

* Graduate of an accredited school of professional nursing.

*Minimum of two (2) years acute hospital clinical experience is required.

* Recent experience in case management, utilization review, discharge planning, ongoing monitoring and evaluation of patient care delivery process is necessary.

* Must be self-directed, assertive and creative in problem solving, systems planning and patient care management in high volume work environment.

* Ability to work effectively, collaboratively with multi-disciplinary teams in multiple environment is necessary.

Licensure/Certification

* Licensed RN in the State of Florida is required.

* Bachelor of Nursing is preferred. (BSN)

_Position Highlights and Benefits_

+ Comprehensive benefit packages available, including medical, dental, vision, paid time off, 403B, and education assistance.

+ We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.

+ We live and breathe our guiding behaviors: we support each other in serving, we communicate openly, honestly, respectfully, and directly, we are fully present, we are all accountable, we trust and assume goodness in intentions.

_Ministry/Facility Information_** **_:_

+ Holy Cross Hospital in Fort Lauderdale, Florida is a full-service, non-profit Catholic hospital, sponsored by the sisters of Mercy and a member of Trinity Health.

+ We are committed to providing compassionate and holistic person-centered care.

+ We are the only Catholic hospital in Broward and Palm Beach counties and are not for profit. We are part of Trinity Health, one of the largest multi-institutional Catholic health care delivery systems in the nation. Together, we serve people and communities in 21 states from coast to coast, providing nearly 2.8 million visits annually.

+ Comprehensive benefits that start on your first day of work

+ Retirement savings program with employer matching

_Legal Info_

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran