Utilization Review Coordinator jobs in Oregon

Utilization Review RN

Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM

Asante is more than a great hospital system in an amazing location. We are a community of passionate providers and service-focused caregivers who collaborate to deliver amazing patient outcomes; a place where titles don't matter as much as your creativity, drive, and passion. Our culture, values and people create an environment of sustained medical excellence.

The Utilization Review Nurse monitors utilization practices from preadmission to discharge to assure cost-effective, quality patient care and to ensure that patient, physician, and hospital/system receive maximum benefits from the health plan. Also ensures compliance with all regulatory requirements involved in the continuum of care. In this role, general responsibilities include:

• Receiving and disseminating information related to system, departmental, and patient processes
• Participating in data collection activities to support departmental programs and services
• Monitoring and reporting on patient outcomes and actively working with other members of the interdisciplinary team to facilitate improved delivery of cost-effective services
• Conducting utilization review, evaluating clinical information, and communicating findings to payors within the framework of contractual and government regulations
• Reviewing all admissions for appropriate inpatient vs. outpatient / observation status

• Bachelor's degree in Nursing - OR - at least 2 recent years of demonstrated utilization/case management experience in a recognized program may be considered in lieu of degree
• RN: Registered Nurse licensed by Oregon State Board of Nursing is required upon start

Preferred Certifications

• CCM: Certified Case Manager
• CPHM: Certified Professional Healthcare Management

• Competitive starting wage
• Comprehensive benefits including medical, dental, vision, and wellness
• Excellent retirement package with up to 6% employer contribution
• Generous Earned Time Off
• Tuition reimbursement after one year of service

Asante is a local, community owned and governed, not-for-profit organization that provides comprehensive health care services to more than 550,000 people in a nine-county area of Southern Oregon and Northern California. It includes Asante Ashland Community Hospital in Ashland, Asante Rogue Regional Medical Center in Medford, Asante Three Rivers Medical Center in Grants Pass, Asante Physician Partners throughout the Rogue Valley, and additional health care partnerships. Virtually all medical specialties and services are represented within an organization dedicated to providing exceptional care. With over 5,000 employees, Asante's entities offer outstanding opportunities for career advancement and professional growth. At Asante your work positively impacts your family, friends, neighbors and the community. Experience the difference in how you work, how you live and how you connect.

At Asante we are defined by our values - traits that guide us as we serve patients and the community:

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.