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RN, Utilization Review

San Luis Valley Health
Full-time
On-site
Alamosa, Colorado, United States
$30 - $41.89 USD hourly
Healthcare Insurance and Claims

The salary range displayed represents the typical salary 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.


San Luis Valley Health is seeking a Registered Nurse, Utilization Review to join our Patient Accounting team! This position works to develop, implement, train, and monitor quality management functions of SLVH. The Utilization Review Nurse educates facility staff and sustains a proactive approach to ensure quality care is provided to our patients.   


What you'll have:

· Licensed RN in the State of Colorado  

· Minimum of 5 years’ experience in management and/or patient safety and quality improvement   

· Utilization Review experience preferred, but not required   

 

What you'll do:  

· Manage the Utilization Review program for SLVH in accordance with CMS conditions and participation.   

· Serve as Chair for Utilization Review Committee.  

· Communicates appropriate information from data sources to insurance companies, departments and committees as required.  

· Performs focused chart reviews and coordinates concurrent review with the medical records department.   

· Develops focused indicators for diagnosis/disease process and educates the Medical Staff on application of these indicators.   

· Maintains a system for tending and analysis of average length of stay, case mix analysis, and observation to inpatient conversion.   

· Other duties as assigned or required to ensure regulatory compliance and quality care and outcomes.   


We Take Care of Our People

 

As the largest employer in the San Luis Valley, we commit to providing our employees with quality and affordable benefits to complement a fulfilling work experience and help balance life experiences and needs. To show our appreciation of your hard work, we offer a competitive and comprehensive total benefits package, including:

  • Full medical, dental and vision plans to suit the needs of you and your family, with low-cost copays and deductibles, all without high out-of-pocket expenses.
  • Enjoy a generous amount of Paid Time Off and Sick Leave in your first year with accruals starting on your first day!
  • Start saving with Retirement plans available from day one, providing up to 5% employer match after one year of employment.
  • Free life and disability insurance benefits for full-time employees with the opportunity to purchase additional coverage at low costs.
  • Add to your benefit package with a variety of voluntary benefits such as identity theft protection, medical and dependent care flexible spending accounts and more.
  • Take care of yourself with our free on-site 24-hour employee health center, and discounts to a selection of local fitness/recreational centers.
  • Keep learning by utilizing our education program benefits to foster your growth and development.
  • Give back to the community with multiple opportunities throughout the year to volunteer with our own non-profit SLV Health Foundation and other SLV- and community-sponsored events.
  • Discounts on cell-phone plans, ski/snowboard lift tickets, Dell computers, local pools, Adams State University functions and more!
  • Your family is our family so our employees and their family members have access to our employee support services, including up to four free counseling sessions to assist with work/life solutions.  

Like to learn more? Click here for more information on our employee benefits program!

Apply now
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