11 utilization review rn jobs found

About this Job: General Summary of Position Responsible for the facilitation and management of medical appeals and may assist with clinically oriented claims issues. Investigates and resolves member and practitioner appeals within plan regulatory and accreditation timeframes. Performs ER review activities.We recruit retain and advance associates with diverse backgrounds skills and talents equitably at all levels. Primary Duties and Responsibilities   Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations. Abstracts medical record analyzes clinical information and Approves payment of services in accordance with NCQA Maryland COMAR the District of Columbia contract and MedStar Family Choice Policies/Procedures. Conducts an initial medical record review for all clinical appeals including inpatient and...

About this Job: General Summary of Position Delivers expert nursing care in helicopters and ambulances to patient and family whose needs range from uncomplicated to highly complex. Receives direct supervision from the Operations Managers May at times receive functional supervision from the VP Director AVP Clinical Operations and Medical Director. Must maintain a weight not to exceed 250 pounds in gear. Required to work in confined space with exposure to extreme temperatures vibration and altitude; and to stand for extended periods of time. Required to physically lift and transfer patients and lift and move equipment used for patient care and other sensory facility to provide patient care. Communicates directly and uses aircraft headsets radios and telephones with patients physicians and other staff in emergency and daily patient care activities. May be exposed to personal safety hazards in both air and ground transport.All associates hired to work in this job area or role require...

About this Job: Please Note: This position is an Evening/ Night shift   General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel. Ensures the provision of holistic culturally competent and person-centered quality safe and cost-effective evidence-based nursing care for patients/families. Applies the nursing process within the context of the organization's shared/collaborative decision-making framework. Collaboratively manages the patient's transitions across the continuum of care to assist patients and populations in achieving or maintaining an optimal level of health and functioning.The Assistant Director of Nursing assumes administrative and leadership...

About this Job: Director of Nursing, Psychiatry (Nurse Manager) Job Overview   The Nurse Manager (Director of Nursing) is a member of MedStar Health entity-based Division of Nursing's (DON) leadership/management team and is responsible for the adult inpatient psychiatric unit, child and adolescent psychiatric unit and psychiatric ED unit of organized nursing and patient care services.     Adult Inpatient Unit Highlights 29-bed acute adult inpatient psychiatry  Evidenced-based mental health treatment Hospital-based Protection Services (Security) Department Experienced leadership Opportunity to be engaged with change management High Reliability Organization with a Just Culture/Culture of Safety Supportive environment     Psych Crisis Stabilization Unit Highlights   10-bed busy specialized psychiatric emergency unit, located within the main medical ED   Treats pediatric and adult patients   Security has a strong partnership and...

About this Job: General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel. Ensures the provision of holistic culturally competent and person-centered quality safe and cost-effective evidence-based nursing care for patients/families. Applies the nursing process within the context of the organization's shared/collaborative decision-making framework. Collaboratively manages the patient's transitions across the continuum of care to assist patients and populations in achieving or maintaining an optimal level of health and functioning.The Assistant Director of Nursing assumes administrative and leadership authority and responsibility on a 24 hours/7 days per week...

About this Job: Director of Nursing, Intensive Care Unit (Nurse Manager) Job Overview   The Nurse Manager (Director of Nursing) is a member of MedStar Health entity-based Division of Nursing's (DON) leadership/management team and is responsible for the comprehensive medical ICU, neurological ICU and patient care services.     Intensive Care Unit Highlights 42-bed unit including 15 beds dedicated to Neurological Critical Care Patients Servicing a wide patient population set included but not limited to medical, respiratory, cardiac, renal failure, GI and surgical patients     General Summary of Position The Director of Nursing is a member of MedStar Health entity-based Division of Nursing's (DON) leadership/management team and is responsible for one or more defined units/departments of organized nursing and patient care services. Creates a practice environment that exemplifies the values of patient care and implements a patient and nursing care delivery system...

About this Job: General Summary of Position The Nursing Professional Development (NPD) Specialist functions within the roles of educator change agent consultant evidence-based practitioner and leader. The NPD Specialist is responsible for assessment planning development implementation and evaluation of learning and development programs that enhance associates' performance promote professional development or otherwise support the mission vision and SPIRIT Values of MedStar Health and the Department of Nursing.  Experience in Electrophysiology and Cardiac Cath Lab is required.   Primary Duties and Responsi bilities   LEARNING AND EDUCATION1.Demonstrates clinical expertise leadership communication skills and knowledge of education theory and principles necessary to develop learning programs and achieve optimal educational outcomes. 2.Designs implements and evaluates designated learning and educational programs and consultative services. Assesses learning needs through...

About this Job: Please note:  This position will be working days and evenings and will have 24/7 accountability on rotating weekends.   General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel. Ensures the provision of holistic culturally competent and person-centered quality safe and cost-effective evidence-based nursing care for patients/families. Applies the nursing process within the context of the organization's shared/collaborative decision-making framework. Collaboratively manages the patient's transitions across the continuum of care to assist patients and populations in achieving or maintaining an optimal level of health and functioning.The...

About this Job: General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nursing and leadership team. Supports and collaborates with the Director of Nursing in providing leadership and oversight for a specific unit/department. Directs and coordinates the nursing and patient care delivery of the unit-based professional and support personnel. Ensures the provision of holistic culturally competent and person-centered quality safe and cost-effective evidence-based nursing care for patients/families. Applies the nursing process within the context of the organization's shared/collaborative decision-making framework. Collaboratively manages the patient's transitions across the continuum of care to assist patients and populations in achieving or maintaining an optimal level of health and funThe Assistant Director of Nursing assumes administrative and leadership authority and responsibility on a 24 hours/7 days per week basis for...

About this Job: Please note:  This is a night shift opportunity.  The schedule is 10pm-8:30am with rotating weekends.    General Summary of Position The Clinical Administrator is a member of MedStar Health entity-based Division of Nursing and leadership team. The role is accountable for directing and supervising clinical and administrative resources to ensure the provision of holistic culturally competent quality safe and cost-effective evidence-based nursing care for patients and families. This is accomplished by direct action delegation coaching and support of the Division of Nursing's associates and shared/collaborative governance activities. The Clinical Administrator is recognized as a professional role model and clinical expert who promotes a professional practice and care environment that supports continuous learning.The Clinical Administrator assumes leadership authority and responsibility during a specific shift (e.g. day evening night and/or weekend) either for a...

About this Job: General Summary of Position The Clinical Administrator is a member of MedStar Health entity-based Division of Nursing and leadership team. The role is accountable for directing and supervising clinical and administrative resources to ensure the provision of holistic culturally competent quality safe and cost-effective evidence-based nursing care for patients and families. This is accomplished by direct action delegation coaching and support of the Division of Nursing's associates and shared/collaborative governance activities. The Clinical Administrator is recognized as a professional role model and clinical expert who promotes a professional practice and care environment that supports continuous learning.The Clinical Administrator assumes leadership authority and responsibility during a specific shift (e.g. day evening night and/or weekend) either for a designated number of patient care units/departments or the hospital at large. Collaborates with the members of...