Prn Utilization Review Jobs in Virginia (NOW HIRING)

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Job Summary:
The Unit Clinical Care Coordinator (Unit C3) is responsible for overseeing the admission process, patient progression, care coordination, and discharge planning within the nursing unit to ensure operational efficiency. Reporting to the Care Coordination department, the Unit C3 acts as the primary liaison between the nursing unit and various stakeholders, including admission sources (e.g., ED, OR), the hub (bed planning) command center, diagnostic and procedural areas, as well as clinical and ancillary teams. This role ensures that patients are progressing according to the care plan, there is efficient utilization management, treatment plans are executed promptly, and discharge planning is appropriately coordinated. The Unit C3 also leads cross-functional collaboration aimed at improving patient throughput, optimizing length of stay, and driving positive patient outcomes throughout the organization.

Essential Functions and Responsibilities:

• Manages, patient progression, care coordination, and discharge planning to ensure optimal system efficiency and continuity of care.
• Assists unit leadership with unit admission and discharge processes. Conducts admission assessments for designated patient populations to identify patient discharge needs and develops a comprehensive discharge plan addressing those needs, potential barriers, and readmission risks. Collaborates with ancillary services (e.g., PT, OT, Social Work) as needed to ensure a well-rounded and effective plan.
• Leads the clinical care team, including nurses, physicians, social workers and ancillary staff in daily SNAP huddles to align discharge goals. Identifies and addresses any barriers to patient progression and discharge, ensuring timely and coordinated care. Manages documentation of designated patient progression elements in the care coordination software to include the classification, documentation, and resolution of progression and discharge barriers; escalates unresolved barriers to senior leadership via escalation huddle. Ensures timely and ongoing communication of unit capacity status with the Hub to support efficient system throughput and optimal patient flow.
• Partners with virtual Utilization Review (UR) Nurse to align payor and status requirements with patient's clinical progression; verifies appropriate regulatory letters are delivered to patient and family when indicated.
• Coordinates patient's plan of care in collaboration with appropriate clinicians for efficient sequencing of care/interventions.
• Communicates progression and discharge plan to the patient and/or their designated proxy in coordination with the patient's primary care team (RN, physician).
• Oversees and ensures care team's timely compliance with patient's preprocedural requirements for service department diagnostics and procedures; ensures communication of service event issues with care team.
• Consults and educates medical and nursing staff on resource utilization, payor requirements, and community resources, while serving as a resource for unit associates on patient progression and care coordination.
• Performs other duties as assigned

Qualifications

• Associate's degree in nursing, required.
• Valid RN License from Virginia or reciprocal compact state, required.
• Minimum of three (3) years of recent acute care nursing experience, required.
• Bachelor of Science in Nursing, preferred.
• Charge Nurse or Case Management experience in an acute care setting strongly preferred.
• ACM (American Case Management) Certification, preferred.
• Able to work independently, managing time, multiple priorities, and resources to achieve goals.
• Able to maintain a calm demeanor and command during times of crisis management.
• Able to assimilate information quickly to produce sound decisions and recognize situations that require immediate intervention.
• Able to articulate information and ideas clearly through both written and verbal communication.

MWHC will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status (EOE). We are also committed to equitable and transparent compensation practices and comply with all applicable pay transparency and pay equity laws.

Required

Physical Requirements: Constant (67-100% of workday) use of arms and hands; frequent (34-66% of workday) standing, walking, and sitting; occasional (0-33% of workday) bending, stooping, and squatting; ability to lift 35 lbs.; ability to push and pull up to 20 lbs.; auditory and visual skills to include color determination.

Mental Requirements: Possesses critical thinking and analytical skills. Ability to multi-task. Ability to communicate effectively and collaborate with a multi-disciplinary team. Capacity to cope with difficult situations. Ability to tolerate irregular hours including evenings, nights, and weekends.

Environmental Requirements and Exposure Hazards: Potential risk of exposure to radiation and toxic chemicals. Potential for exposure to bloodborne pathogens; must be able to wear appropriate personal protective equipment.

"It is the policy of Mary Washington Healthcare to provide reasonable accommodations to qualified individuals with a disability who are applicants for employment or Associates."

Compensation Pay Range:

$39.44 - $59.15