UnityPoint Health RN Utilization Management Spclst-Case Management-Methodist in Des Moines, Iowa
Provides the utilization review function for patients admitted to UPH-DM. Facilitates effective utilization of resources through ongoing interactions with physicians, third party payers and regulatory agencies. Provides education to patients and families regarding the role of the Utilization Management Specialist and provides clarification when needed on level of care and their payer source regulatory requirements. Provides education to staff and physicians regarding medical necessity, levels of care and appropriate utilization of resources. Pursues denials at the affiliate level to secure payment of services.
Choose a career that matters with UnityPoint Health Des Moines! UnityPoint Health - Des Moines is a family of four hospitals including Iowa Methodist Medical Center, Iowa Lutheran Hospital, Blank Children's Hospital and Methodist West Hospital. Our team members are the compassionate core of who we are and how we serve our patients and visitors every day.
Assumes joint accountability with other staff members for the coordination of discharge needs for patients and the families. The patients and families needs are assessed, evaluated and monitored upon admission to the hospital, during the hospital stay, prior to discharge, and at the time of discharge.
Current Iowa License to practice as a RN. Two years of clinical experience in focused areas working with multidisciplinary teams. Bachelor of Arts/Science degree in health care related field required or the commitment to complete within a five year timeframe. BSN preferred.
Requisition ID: 2020-85040
Street: 1200 Pleasant St
Name: 3020 UnityPoint Health Des Moines
Name: Case Management
FTE (Numeric Only; Ex. 0.01): 1.0
FLSA Status: Exempt
Scheduled Hours/Shift: Days 8-430 pm Rotating Weekends/Holidays
External Company URL: http://www.unitypoint.org