RN Utilization Review Full Time Days

Lakewood, CO
Jul 03, 2018
Jul 31, 2018
Managed Care, Other
Contract Type
Full Time
St. Anthony Hospital is located in the western Denver suburb of Lakewood and is a Level I Trauma Center with four dedicated trauma rooms including the T-10 room, a dedicated field-to-surgery suite ready 24/7 for trauma surgeons and specially trained teams who provide life-saving care to the most severely ill and injured patients. St. Anthony proudly provides a full range of medical specialties and health care services to Denver and the surrounding region with a state-of-the-art medical campus. If you’re looking to be part of a fast-paced environment where you can practice to the top of your profession in trauma, cardiology, stroke, neurosciences, breast imaging, cancer/oncology care, surgery and more, we encourage you to apply. In addition to a new campus, supportive team and faith-based mission, we’re proud to be the recipient of numerous awards, certifications and accreditations from the American Heart Association; Chest Pain Center (CPC); American College of Cardiology; The Joint Commission’s National Quality Approval; Healthgrades (for Stroke, Critical Care and Prostate Surgery Excellence); the Emergency Nurses Association Lantern Award; NAPBC Accreditation; American College of Radiology and many others. For more information about St. Anthony Hospital, visit http://www.stanthonyhosp.org/.

Job Description/Job Posting ID: 130045

Recruiter Contact: MandyGray@Centura.org

Clinic/Department: 8675 SAH CASE MANAGEMENT


Schedule: Full Time Days-0.90 FTE

Shift: 8a-4:30p- NOT A REMOTE POSITION- will rotate weekends- typically 2-3 weekend shifts in a 6 week period. Will work with physician advisor, insurance companies, will visit patient rooms, need to be a good communicator.

Up to $5000 sign on bonus for experienced RN Case Managers- 2 year agreement required-Not valid for current employees

Position Summary

The RN Case Manager reports to the Case Management Director or Manager/Supervisor. The RN Case Manager utilizes clinical expertise, discretion, and independent judgment in assessing/reassessing, facilitating care coordination, and patient advocacy. The RN Case Manager is responsible for assuring medical appropriateness criteria are met for status and level of care. The RN Case Manager provides and documents all case management and utilization review activities from admission thru discharge. The RN Case Manager collaborates with the interdisciplinary team in order to implement a comprehensive and safe discharge plan thru out the continuum of care for the patient. RN Case Manager collaborates with the interdisciplinary health care partners in quality/patient safety outcomes. RN Case Managers assess readmission and problem solves interventions. The RN Case Manager evaluates/re-evaluates the plan of care and ensures continued appropriateness of the plan is provided based on the patients changing needs and condition. The RN Case Manager maintains working knowledge of specialized case and utilization management methodologies options and services to meet an individual’s health needs.

Minimum Education Requirements

RN with ADN required

BSN strongly preferred, required for Centura Magnet facilities

Minimum Experience Requirements

Three years of recent acute care experience

Experience in working with EMR

Working knowledge of regulatory requirements and accreditation standards preferred.

Must be assertive and consistent in following and/or enforcing policies and processes.

Must be able to provide clinical expertise while organizing and prioritizing work load.

Able to work independently with minimal supervision, accept direction, and demonstrate problem solving skills.

Must be able to perform duties of the job such as walking rounds, face to face patient assessments, and navigate patient rooms.

Able to communicate professionally and effectively with all care team staff, patients and families.

Use of computer technology necessary to the position.


State of Colorado RN License

Physical Requirements

Light Work - exert/lift up to 20 lbs. force occasionally, and/or up to 10 lbs. frequently)


Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V.

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