SHIFT: PRN SCHEDULE: PRN/Per Diem Hourly Wage Estimate: $39.03 - $58.52 / hour Learn more about the benefits offered for this job.
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.
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This is a PRN (as needed) position for Utilization Review in Behavioral Health. Primary responsibilities will include telephonic review with insurance and payers, onsite at our Behavioral Health Campus.
Our Case Management teams are a committed, caring group of colleagues. We have a passion for creating positive patient interactions. If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Here is some of what you can expect from being a Case Manager with us:
You will coordinate services through an interdisciplinary process, which provides a clinical, financial, and psycho-social approach through the continuum of care
You will balance individually identified patient and family needs with the efficacious and cost effective utilization of resources
You will assess patients to determine appropriateness of admission, continued hospitalization, clinical resource consumption, progressive care management, as well as appropriate level of care
You will participate in discharge planning at the time of (or prior to) admission, and reassess throughout the course of hospitalization
You will support collaboration and communication among the patient/family and entire health care team regarding the patient's plan of care and continued needs post-discharge and facilities those services required
You will perform telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery of patient care services
You will identify quality and/or risk issues and reports to the appropriate individual/department
Qualifications you will need for this role:
Current licensure in the State of Colorado as a Registered Nurse; LCSW, LPC, LMFT, BLS – Healthcare provider through the American Heart Association or American Red Cross
Special certification in case management preferred
Graduate of an accredited school of nursing, BSN or Master Degree in Mental Health Related Profession (LCSW or Marriage & Family Counselor).
5 or more year’s clinical experience required
1 to 3 years Case Management experience preferredwith emphasis on utilization review (Behavioral Health Utilization Review preferred).
Ability to assess information, apply critical thinking processes to determine course of action, define expected outcomes and evaluate effectiveness of plan through continuous assessment of the patients progress
Ability to compile, evaluate and report statistics to members of the team and utilize the information to facilitate process improvement activities
Strong oral/written communication skills are necessary for meeting facilitation, educational presentations, team collaboration and patient interviews
Requires excellent human relations skills and strong analytical/organizational skills
Must have ability to perform multiple tasks simultaneously and work in high stress environment
Position requires flexibility and cross coverage
The Medical Center of Aurora, the first community hospital in the Denver Metro area to receive three-time Magnet designation for nursing excellence by the American Nurses Credentialing Center (ANCC), is a 346-bed acute care hospital located in Aurora, Colorado. The Medical Center of Aurora is comprised of six campuses in Aurora and Centennial, Colo., including the Main Campus, located at Interstate 225 and Mississippi, the North Campus Behavioral Health and Wellness Center, Centennial Medical Plaza, Saddle Rock ER, Spalding Rehabilitation Hospital, Spalding Rehabilitation at P/SL, and a medical office building at Green Valley Ranch. The Main Campus facility is a Level II Trauma Center with Primary Stroke Certification and Chest Pain Center accreditation, and has an affiliation with Rocky Mountain Hospital for Children as well as the Sarah Cannon Cancer Institute. The Medical Center of Aurora was named to Healthgrades 2020 America’s 250 Best Hospitals, putting TMCA in the top five percent of U.S. hospitals for clinical outcomes. The Medical Center of Aurora is proud to be a part of the HealthONE system of hospitals.
Be a part of an organization that invests in you. We are actively reviewing applications. Highly qualified candidates will be promptly contacted by our hiring managers for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Join our HealthONE family -- the largest healthcare system in the Denver metro area. Eight world-class hospitals. 40+ outpatient facilities. Countless opportunities.HealthONE is an equal opportunity employer.