Utilization Review Nurse

Job Details

Job Location
Greenville SC - Greenville, SC

Position Type
Full Time

Travel Percentage
Local Travel

Job Shift
Day

Description

VIA Health Partners is an industry leader and top-10 nationally ranked provider of end-of-life care. More importantly we are proud to be a community based, not for profit hospice & palliative care provider. We have deep community roots, with decades of experience serving ALL patients' and families' needs regardless of their ability to pay or their medical complexity. We are a people first organization whose funds go to serve our mission.

Due to our significant growth, we are looking for amazing new staff who share these same values. Apply now and be a part of our success story.

We provide excellent benefits including:

• Medical, Vision, and Dental plans through BCBS
• 28 days of Paid Time Off
• Excellent mileage reimbursement rate
• 403b Retirement plan with matching
• Focused programs honoring Veteran patients
• Assistance with achieving Certified Hospice & Palliative Nurse (CHPN)
• Best Orientation and Onboarding program you've experienced
• Seasoned Hospice leaders guiding your career growth

Essential Functions
Palliative Medicine Referrals

• Requests orders on hospital discharge referrals.
• Acts as liaison between Referral Center and Palliative Medicine RNs to facilitate hospice transitions and resolved issues related to referrals.
• Routinely monitors pending referrals to assure resolution of status.
• Obtains additional records, as needed/requested, for home, independent and clinic referrals.
• Assessment of new referral and patient data to determine if patient is hospice eligible and assist with timely hospice admission.
• Collaborates with PM Nurse Liaison, Utilization Review Nurse, and Patient Service Coordinators to assure visit schedules are accurate.

Patient Data

• Updates Cerner profiles as needed:
  • Referral Status
  • Discharges
  • Location
  • Contact information

Maintains Professional Relationships with other Depts, Providers, Patients and Families, and Vendors

• Utilizes feedback to provide excellent customer service.
• Receives and responds to emails/voice mails as necessary.
• Presents and maintains a highly professional image.

Assumes responsibility for establishing and maintaining effective working relationships with leadership and staff in other departments.

• Attends meetings and participates actively in internal organizational activities. Reports and acts on potential issues for improvement, participates in work groups, and participates in quality assurance audits as needed.
• Keeps other leadership and supervisors well informed of area activities and of any significant problems.
• Serves as a back to other teammates during PTO and time away from work.

May perform other duties as required

Qualifications

Minimum Qualifications

• Associate degree in a related technical discipline, or the equivalent combination of education, technical certifications, training, or work experience. Bachelor's degree preferred. Nursing or Social Work background is a plus.
• Minimum of two years of related experience in an office environment, preferably in a health care facility/setting, or the equivalent combination of education, technical certifications, training, and work experience.
• Proficiency in Microsoft Office and Excel are required.