Swing Shift RN Clinical Review Management

Clinical Review Management System Office Position Type Full-Time Shift Swing Job ID 157053 City State ID Category Nursing - Experienced Description & Requirements At St. Luke’s, our dedicated team of Clinical Review Nurses strive to build a positive, supportive, and inclusive culture that delivers exceptional patient experiences. What You Can Expect: 8-hour shifts, 3-11 PM Intensive paid training Reviews the medical necessity of admission, continued hospitalization, length of stay, and any potential denial of payment issues. Applies established criteria and employs clinical expertise to interpret clinical criteria to determine medical necessity of services. Performs Medicaid and Medicare review. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Communicates results of reviews to the primary care team, specialty providers, vendors and members in adherence with regulatory and contractual requirements. Fully Benefitted Sign On Bonus Eligible Qualifications: Education: Bachelor of Nursing or Associates of Nursing Degree Experience: 3 years of RN or utilization management experience (BSN) or 5 years of RN or utilization management experience (ASN) Licenses/Certifications: Current RN license in Idaho For more information, contact Julie at View email address on click.appcast.io What's In It For You At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. *Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers. #J-18808-Ljbffr