Utilization Review RN in Alameda, CA at Aerotek

Posted: 8/26/2019

Job Snapshot

  • Employee Type:
    Contract to Hire
  • Location:
    Alameda, CA
  • Posting ID:
  • Pay Rate
    $45.00 - $56.00/Hour

Job Summary

The Inpatient Utilization Management (UM) RN is responsible for conducting on-site and telephonic utilization review of hospitalized members and initiating the transition of care process. The Inpatient UM RN works directly with hospitals and primary and specialty care providers to meet the targeted needs of each individual member and their families.
  • Must have active CA RN license
  • At least 1 year of experience within Utilization Review
  • Acute care experience
  • Flexibility once trained to work remote a few days

Responsibilities Include:
- Perform timely concurrent review of inpatient admission to ensure it meets medical necessity guidelines
- Provide weekend coverage, when required, for assigned hospitals to ensure member discharge needs are met.
- Use clinical judgment to assess and stratify members for appropriate levels of need and refer member to the Case and Disease Management department, if necessary.
- Identify patients eligible for hospital discharge or transfer to lower level of care; assist in coordinating discharge planning needs with hospital staff, vendors, etc as appropriate.
- Coordinate with admitting, attending, PCP, case manager, social workers, and other liaisons regarding the patient's acuity level and plan of care.
- Communicate as needed with the Medical Director to validate patient acuity and plan of care; refer admissions for potential denial to the Medical Director

About Aerotek:

We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email accommodation@aerotek .com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

Contact Information

Kateri Tillman