This position is located at the Chinle Service Unit, Division of Quality Management, Chinle, AZ. The purpose of this position is to serve as a Utilization Management Nurse/Compliance Officer. Incumbent ensures through reviews and audits, patients receive care without burdening the health care system with unnecessary procedures. Position requires knowledge and skills in applying, the principles, concepts, practices, and procedures of specialized nursing care to patients of Utilization Review.Learn more about this agency
- Assesses, plans, monitors and evaluates patient care through utilization review activities.
- Reviews and analyses inpatient and outpatient medical records based on advanced nursing knowledge to identify deviations from screening criteria.
- Monitors timelines of use and response by ancillary services.
- Identifies possible admission clinical discrepancies and discusses clinical findings with the attending physician.
- Communicates clinical discoveries with physician reviewer and the requesting provider to obtain clinical decision.
- Assists the Compliance Officer in planning, implementing, evaluating, a comprehensive hospital.
- Aides with mock survey activities, quality rounds, on the spot education.
- Prepares clinical nursing reports for dissemination during inpatient Discharge Planning Coferences.
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This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/566640400. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.