Utilization Review Department
Full-time position (36 hours per week). Works Monday through Friday; four nine-hour shifts. Hours are 6:00 am to 3:30 pm OR 7:00 am to 4:30 pm OR 7:30 am to 5:00 pm. Is responsible for facilitating the patient’s hospitalization from pre-admission through discharge. Coordinates with physicians, nurses, social workers, and other health team members to expedite medically appropriate, cost-effective care. Applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning. Will advise the healthcare team and provide leadership as needed. Is responsible for assessing the medical appropriateness, quality, and cost-effectiveness of hospitalized patients in accordance with established criteria. This review activity may be conducted prospectively, concurrently, or retrospectively and in collaboration with patients, physicians, and other professionals. Will provide case management intervention by assessing, monitoring, evaluating options and services to effect appropriate, individualized plan for the patient across the continuum of care. Must be a graduate from an approved Professional Nursing program. Must be a Registered Nurse currently licensed in the State of Iowa. Prefer individual with at least five years experience in clinical nursing; previous utilization review and case management experience also preferred. Computer knowledge required.