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RN - UR/TOC & Denials - FT - Evenings - $6,000 sign-on bonus

Company: Norman Regional Health System
Location: Norman
Posted on: November 21, 2022

Job Description:

Overview:Position is eligible for $6,000 sign-on bonus!!! The Utilization Review/Transitions of Care and Denials team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission, required level of care of service, social determinants of health, and apply contractual criteria related to payor plans during appeal of denials. The Utilization Review/Transitions of Care/Denial RN must work with a diverse group of other health care professionals and should be able to work well individually and as part of a team.Norman Regional Health System is a team of more than 3,000 healers all working together to bring our mission and vision to life. Our mission is to serve our community as the leader in health and wellness care. Our vision is to be the provider of choice to improve the health and well-being of our regional communities.Responsibilities:Responsible for performing utilization review screening for all hospitalized patients to assist in determining accurate hospitalization status.Collaborates with Physician staff by reviewing medical record for clinical criteria to medical necessity to insure the appropriate of level of care, and services are delivered to hospitalized patients.Responsible for performing review, audit and appeals of medical necessity, readmission and authorizations denials for inpatient and outpatient.Utilization Review/Transitions of Care & Denials RN should be able to work well individually and as part of a team.Assists with chart and defense audits with outside payers accurately documenting findings and non-findings, and providing clinical/policy/regulatory support for determination; is responsible for providing disease management, care coordination and patient outreach across the care continuum.Coordinates and leads multi-disciplinary and cross continuum meetings to ensure all providers across the care continuum are working in a coordinated effort.Resolves complex problems that require coordination and communication within pre-operative team and acute care team and both community and governmental entities.#NRHSSQualifications:EducationBachelor of Science in Nursing (BSN) or Masters of Science in Nursing (MSN) preferred, Associate degree of Nursing (A.D.N.) required.ExperienceMinimum of three years' experience in acute care patient setting.Minimum of one year experience in Clinical Documentation or Appeal/Denial Management experience preferred.Utilization Review or Case Management experience preferred.(Above requirements can be met by equivalent combination of education and experience)Licensure/CertificationCurrent OK RN license required.Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.Compensation/Benefits$28.95-$47.28/hr depending on previous work experience.Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.

Keywords: Norman Regional Health System, Norman , RN - UR/TOC & Denials - FT - Evenings - $6,000 sign-on bonus, Other , Norman, Oklahoma

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