Utilization Review Nurse

Company: University of New Mexico - Hospitals
Location: Albuquerque
Posted on: September 21, 2023

Job Description:

Department: Utilization Management
FTE: 1.00
Full Time (30 - 40 hours per week)
Shift: Days
Position Summary:
Function as a department educator, master teacher, master preceptor for Case Management for both RN And SW education. Department Educator will coordinate care management orientation and professional development activities. Serve as a staff resource regarding case management, professional practice, accreditation and licensure regulations. May contribute to professional knowledge and to the Hospital's educational mission through professional presentations, participation in research, publication of articles and/or participation in professional associations. Ensure adherence to hospitals and departmental policies, procedures and guidelines. Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups.
Detailed responsibilities:
* PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols
* DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
* PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
* PATIENT SAFETY 3 - Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk
* PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner
* PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"
* LEAD - Provide educational leadership to enhance specialized patient care within clinical protocols
* ASSIST - Assist patient and caregivers with educational needs, problem solving, and health management aspects across the continuum of care
* MONITOR - Monitor trends and implement educational strategies to ensure quality standards and parameters are achieved
* EDUCATE - Educate appropriate staff in the use of new equipment, supplies, and instruments for their service; coordinates in-service training/workshops for appropriate staff
* PLAN - Plan orientation and mentor/preceptorships for new department staff in collaboration with department leadership
* DEVELOP - Develop new case management education programs and tools as necessary to meet the quality and patient care needs of the department
* COLLABORATE - Collaborate with Unit Director, Social Work Manager, and RN Supervisors to plan and implement pertinent curricula
* CONSULT - Consult with other departments and multidisciplinary team members as needed to ensure quality patient care and to develop quality educational tools.
* SUPERVISION - Assist Social Work Manager with coordinating or providing clinical supervision to Care Management Social Work Case Managers
* EDUCATION - Assist in identifying the educational needs for both nurse and social work staff including needs identified for peer support, new resources, programs and quality issues

Qualifications
Education:
Essential:
* Program Graduate
* Bachelor's Degree
Education specialization:
Essential:
* Nationally Accredited Nursing Graduate
* BSN w/in 36 Months of Position
Experience:
Essential:
2 years directly related experience

Nonessential:
5 years directly related experience
Credentials:
Essential:
* RN in NM or as allowed by reciprocal agreement by NM
* CCM or ACM-RN or RN-BC within 6 mos
* CPR for Healthcare/BLS Prov or Prof Rescuers w/in 30 days

Physical Conditions:
Light Work: Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. May require walking or standing to a significant degree or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or may require working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of materials is negligible.
Working conditions:
Essential:
* Minor Hazard - physical risks, dirt, dust, fumes, noise
* May be required to travel to various work sites
Department: Registered Nurse

Keywords: University of New Mexico - Hospitals, Albuquerque , Utilization Review Nurse, Healthcare , Albuquerque, New Mexico