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Utilization Management Coordinator Non RN - Care Management

Benefits Eligibility (Employment Type):  Select benefits (0-19 hours per week)
Shift Type:  Day
Shift Length:  8 Hours
Primary Location (City):  Vancouver
State:  WA

PeaceHealth is seeking candidates for a per diem Utilization Management Coordinator position at Southwest Medical Center.  In this per diem role, will work 8 hour Day shifts as needed.

Req ID: 173622

 

JOB SUMMARY

Coordination of the organization’s clinical documentation and utilization management.  Coordination of care across the continuum.  Collaborates and coordinates communication and decisions across the health care team to achieve national standards for best practices, discharge planning, clinical documentation and utilization management functions.  Coordinates discharge planning and implementation.

 

ESSENTIAL FUNCTIONS

  1. Review medical records for determination and documentation of medical necessity for inpatient and/or observations status utilizing established criteria and methods. 
  2. Identifies issues and variations in utilization and escalates to appropriate members of the health care team.  Actively support measures that promote effective use of resources.
  3. Develops and coordinates discharge plans with input and involvement of health care team.  Incorporates priorities and decisions made by patient.  Implements discharge plans in partnership with staff RNs.
  4. Identifies patients at risk for encountering problems post hospitalization and collaborates with Social Services for referral to appropriate discipline team members and outside agencies to support optimum success.
  5. Advocates for Services and funding as appropriate and necessary to meet care plan goals.
  6. Identify, plan and arrange for appropriate services applying knowledge of services available in the community, state, and federal health regulations and admission, discharge and medical necessity criteria.
  7. Facilitates process to support patient’s ability to access and utilize resources that best meet their needs and eligibility criteria.
  8. Demonstrates knowledge of procedures which assure quality care and effective utilization of hospital services; applies this knowledge when coordinating discharge plans and reviewing medical records.
  9. Monitor the individual’s condition and responsiveness to their interventions.
  10. Other duties as assigned.

 

QUALIFICATIONS

EDUCATION:     

  • Bachelor’s degree in related field preferred or 5 years clinical experience in an acute care setting.

 

EXPERIENCE/TRAINING:              

  • Minimum of one year current practical experience in utilization management, risk management, quality improvement preferred.
  • Experience in discharge planning and social services preferred.

 

LICENSE/CERTIFICATION:            

  • Current Washington State LPN or Social Worker licensure preferred.
  • Certification in Case Management highly desired.

 

OTHER SKILLS:  

  • Excellent verbal and written communication skills including sensitivity to other cultures and ethnicities.
  • Excellent skills in conceptual thinking, listening, problem resolution and planning.
  • Demonstrated leadership skills.
  • Excellent organizational skills.
  • Proficient computer skills including MS Office applications and electronic medical records.
  • Knowledgeable about issues related to chronic illness, developmental disabilities, special needs, mental illness, grief and transition, substance abuse, domestic violence, child abuse and senior abuse.
  • Good understanding and adherence to core social work values and ethics.

 

 

SOUTHWEST PHYSICAL/COGNITIVE REQUIREMENTS

 

  • Work requires fairly light physical exertion up to 66% of the time.
  • Ability to lift objects weighing 30 lbs. or less.
  • Work is performed under normal working conditions with adequate lighting and ventilation.
  • Job duties frequently require intense concentration and attention to detail (34-65% of work time).

 

Please apply online to be considered. For full consideration of your skills and abilities, please attach a current resume with your application.

 

About PeaceHealth

 

PeaceHealth, based in Vancouver, Wash., is a not-for-profit Catholic health system offering care to communities in Washington, Oregon, and Alaska. PeaceHealth has approximately 16,000 caregivers, a multi-specialty medical group practice with more than 900 providers and 10 medical centers serving both urban and rural communities throughout the Northwest. In 1890, the Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, PeaceHealth is the legacy of its founding Sisters and continues with a spirit of respect, stewardship, collaboration and social justice in fulfilling its Mission.

 

We offer competitive compensation, a robust benefits package and a collaborative, Mission-driven work environment! To learn more about working at PeaceHealth and the Vancouver community please visit our homepage: www.peacehealth.org/careers.

 

Get a feeling for the Spirit of PeaceHealth through this three-minute video, and visit us on Facebook or LinkedIn!

 

Questions? Review our Employment FAQ or email Recruitment@peacehealth.org. Please note this email does not accept resumes or applications.

 

Location: Vancouver, Southwest Medical Center (150)
Job Category:  Allied, Ancillary & Clinical Support 
Shift:  Day
Shift Length: 8 Hours
FTE: 0.0
Work Type:  Per Diem/Relief
Hourly compensation starts at: $27.24, more depending on experience
Required Certifications/Licensure: 

 

PeaceHealth is committed to providing equal employment opportunities to all qualified job applicants and employees without regard to the following statuses: protected veteran; qualified individual with a disability; race; ethnicity; religion; gender; pregnancy; gender identity; national origin; age; genetic information; sexual orientation; or any other protected status in accordance with local, state, or federal laws.

 

The above information is intended to indicate the general nature and level of work performed by this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of caregivers assigned to this job.

 

Posting Notes: Vancouver || Allied, Ancillary & Clinical Support || Behavioral Health/Social Work || Per Diem/Relief || CLINICAL SUPP SVCS


Nearest Major Market: Portland Oregon
Nearest Secondary Market: Tacoma

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