Utilization Review Nurse Jobs in Racine, WI (NOW HIRING)

At Children's Wisconsin, we believe kids deserve the best.

Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it's like to work at Children's Wisconsin:https://www.instagram.com/lifeatcw/

Job SummaryPediatrician who works as an acute care provider in one or more of Children's Hosptial of Wisconsin's urgent care clinics. Provides appropriate acute pediatric care services. Maintains and complies with all OSHA standards to achieve clinic compliance.Essential Functions- Understands and satisfies the needs of the neonatal, infant, toddler, pre-school, school-age, adolescent and/or adult patient in regards to their growth and development process. - Performs appropriate history, physical exam, assessment and plan, and documents legible, concise and pertinent entries in the medical record according to appropriate policies, rules and regulations. - Develops a differential diagnosis and treatment plan or management of pediatric health care needs using identified protocols established in clinic. Prescribes medication for health care management of pediatric population. - Performs necessary procedures for identification and management of health problems. This includes, but is not limited to suture/staple removal, ear irrigation, foreign body removal, wound care/ repair, and management of corneal abrasions. - May perform point of care testing and lab specimen collections according to established guidelines. - Handles patient needs in a timely manner and communicates well with the parents, patients, etc. regarding the patient's care. - Collaborates/coordinates care between EDTC and Urgent Care stetting to resolve problems/issues in the delivery of the appropriate level of service to Urgent Care patients. - Communicates with hospitalist and primary care physicians regarding condition of patient as warranted, and in accordance with Hospital and medical staff rules and regulations when a patient needs to be admitted to CHW. - Remains available to the urgent care nursing staff and providers if needed for urgent/emergent action and consequently remains on premises at all times during assigned shift. Responds to request for mutual assistance from other urgent care providers. - Participates, when requested, in medical education activities for the urgent care staff, nurses, pediatric nurse practitioners, students, residents and others.Legacy Essential Functions- Participates in answering third party payor and utilization review questions when requested by the urgent care leadership team. - Responds to official patient complaints submitted to patient relations in a timely manner. - Documents all procedures in the medical record for billing purposes. - Enters charges for all billable supplies and procedures performed in the urgent care clinic setting. - Consistently completes modules in Children's University that have been assigned to them by the UC leadership team. - Keeps current on clinic updates, meetings, in-services and communications that affect patient care, services and clinic operations. Education:- Terminal Degree (PhD, MD, etc.) Medical Degree required Knowledge, Skills and Abilities - Current malpractice insurance at a level of $400,000/$1,000,000 as well as participation in the Patient Compensation Fund. - Current DEA number. - CHW medical staff membership in the Department of Medicine with core privileges in pediatrics. - Demonstrated proficiency in skills necessary to manage urgent care patients normally acquired during pediatric residency training. - Must demonstrate good communication and interpersonal skills when dealing with fellow physicians, nurses, patients, families and other staff. - Physically and mentally able to perform all patient care duties. - Good medical record documentation skills as demonstrated by concise and pertinent entries. - Demonstrated ability and interest in teaching, which will include student level and professionals (nurses, pediatric nurse practitioners, interns/residents). Licenses and Certifications: - BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council required - + one of the following: - N/A - License DO (21) - State of Wisconsin - License MD-Medical Doctor (20) - State of Wisconsin - License MD-Medical Doctor (320) - State of Wisconsin Patient Care Responsibility- Provides care appropriate to patient population and as described in applicable policies and procedures. Required for All Jobs: - This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job. - Employment is at-will. This document does not create an employment contract, implied or otherwise.

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses:

American Board of Pediatrics - American Board of Pediatrics, BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council, DEA-Drug Enforcement Certification - US Department of Justice Drug Enforcement Diversion Control Division, License MD-Medical Doctor (20) - State of Wisconsin