LPN Utilization Review Nurse - Care Management - Lawton, OK 73505 - Utilization Review

Company: Comanche County Memorial Hospital
Location: Lawton
Posted on: May 10, 2022

Job Description:

LPN Utilization Review Nurse - Care Management - Lawton, OK 73505 DEFINITION:




--




All duties and criteria-based standards within this document will be performed according to established policies, procedures, and guidelines within the department and hospital.-- In collaboration with the physician and as a member of the health care team you will be responsible for ensuring the patient's progression through the continuum of care in a manner that achieves the desired clinical and financial outcomes.-- Works directly with physicians, staff members, and department managers in identifying opportunities for improvement, developing clinical pathways, clinical practice guidelines, and other methodologies to assure comprehensive, cost effective quality health care services, for inpatient, ambulatory, out-patient and on occasion for individuals not in the health care system. This position also includes obtaining insurance authorizations for Skilled Nursing Units, IP, and sometimes OP procedures. You will also be responsible for insurance denial process, to include but not limited to Retro Authorizations. You will also be back up for other UR staff when they are out or it is overly busy.--
--
EDUCATION:
--Current BLS preferred
--
REGULATORY REQUIREMENTS (IF APPLICABLE):
Current Oklahoma LPN license--------
--
MINIMUM QUALIFICATIONS:
--
PREFERRED QUALIFICATIONS:
Certification in Case Management or related certification preferred.-- The incumbent will possess superior clinical skills and be capable of high level assessment and planning for a particular patient aggregate determined by physician and or diagnosis.-- Three years of recent acute care experience, home health care, or discharge planning, plus prior experience in utilization review are preferred.-- Managed care experience preferred.-- Possesses complex problem solving skills and the ability to organize and respond quickly to large amount of sensory stimuli.-- Has excellent written and verbal communication skills, must be able to relate positively to multi-disciplinary health care team.-- Must be adaptable and flexible.-- Computer competency required.---- Trained in age-specific competencies.-- This is a fast paced environment and must be computer knowledgeable. This is mostly a sitting position.
--
#ZR
--

Keywords: Comanche County Memorial Hospital, Lawton , LPN Utilization Review Nurse - Care Management - Lawton, OK 73505 - Utilization Review, Healthcare , Lawton, Oklahoma