Utilization Review Nurse Jobs in Santa Rosa, CA (NOW HIRING)

POSITION DESCRIPTION: To provide direct patient care and support activities which build and maintain the outstanding outcomes of the therapy department.

ESSENTIAL JOB FUNCTIONS:

Aids in the restoration and enhancement of independent function in those individuals whose living status has been compromised by illness and/or injury: evaluates and treats patients, communicates with families, physicians and other health team members, documents services in the medical record. Contributes to professional development of self and others. Enhances interdisciplinary team through professional skills and knowledge. Demonstrates safe working practices.

Provides patient treatments, which meet patient needs, and uses current treatment knowledge in accordance with facility clinical procedures. This includes but is not limited to:

Performing accurate, comprehensive patient evaluations.

Developing effective plan of treatment and obtaining appropriate approvals from referring physicians.

• Supervising Certified Occupational Therapy Assistants and/or Aides in direct patient care and patient related activities according to facility policy as well as State and Federal requirements.

Communicating with supervisor and other health team members regarding patient progress, problems, and plans.

Instructing patient’s families or nursing staff in specified follow through programs.

Interviewing patient and families regarding previous level of functioning and life style and current and future expectations.

Demonstrating knowledge of appropriate resources for problem-solving and clinical best practice.

Assessing, training, and issuing necessary ADL adaptive equipment and durable medical equipment for patients to facilitate independence in ADLs.

Writes accurate, complete, and clear documentation in accordance with regulatory, licensing, payor, and accrediting requirements. This includes but is not limited to:

Recording Resident Needs Reviews, evaluations, daily treatment notes, progress notes, and discharge summaries in accordance with facility procedures.

Recording treatment charges and insuring that documentation is consistent with billing data.

Writing specific, objective documentation, which is outcome oriented and details the patient’s needs, potential to benefit from treatment, and progress achieved to date. Includes specific, objective, measurable goals.

Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility, and therapy staff.

Acquiring and documenting consents/approvals for treatment when necessary.

Consistently demonstrates the facility’s interdisciplinary approach to patient care. This includes but is not limited to:

Integrating findings of other members of the interdisciplinary team in treatment assessment and recommendations.

Integrating input from patient and family in treatment assessment and recommendations.

Preparing for and providing meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions.

Collaborating with and informing facility staff in areas of patient progress.

Educating members of the team in areas of expertise.

Working with facility to teach documentation practices, which assist the therapy team.

Communicating effectively with discharge planners.

Contributes to professional development of self and others. This includes but is not limited to:

Utilizing continuing education assistance to achieve targeted quality improvements.

Interacting with peer therapist at local acute hospitals and other environments, if appropriate.

Presenting at weekly rehab team conferences, facility in-services, and professional conferences.

Maintaining a current body of knowledge in areas of clinical expertise through seminars, professional journals, and peers.

Meeting continuing education requirements of regulatory agencies.

Aids in building and maintaining a positive facility culture as a professional member of the staff. This includes but is not limited to:

Consistently demonstrating positive core values in interactions with co-workers, patients and families, with all other persons involved with the patient’s care, and the general public.

Consistently demonstrating professional standards.

Contributing to a positive work team by sharing information, using problem-solving methods and accepting new ideas, constructive criticism, or advice from others.

Demonstrating superior customer service through courtesy, consistent follow-up and positive communication.

Demonstrates safe working practices. This includes but is not limited to:

Identifying and correcting safety hazards or notifying the facility or the Director of Rehabilitation so that safety hazards will be immediately remedied.

Maintaining work areas in safe and orderly fashion.

Maintaining equipment in safe working order by facilitation annual calibration.

Using proper body mechanics during treatments of patients and during support activities.

Using universal safety precautions.

Wearing appropriate protective equipment.

QUALIFICATIONS:

Skills, Knowledge and Abilities:

• Knowledge in Occupational Therapy evaluation and treatments.
• Ability to supervise and direct assistants and aides.
• Understanding of the principles of physical modalities employed in Occupational Therapy.
• Knowledge of use of prosthetic and orthotic devices ambulatory aides, assistive and resistive devices, and training.
• Knowledge of medical terminology.
• Ability to work with all types and levels of patients.
• Must have excellent verbal and written communication skills.

Education:

Bachelor’s or Master’s Degree in Occupational Therapy from an accredited Occupational Therapy program.

Experience:

• Experience in geriatric rehabilitation preferred
• Experience in adult neurological, cardiac, and/or general rehabilitation is preferred.

Physical Requirements:

For Direct Patient Care:

Must be able to lift and transfer patients to and from all surfaces a minimum of 10 times per day.

Must be able to lift approximately 50-70 pounds a minimum of 10 times per day.

Must be proficient with the use of hands for repetitive grasping and find motor manipulation.

Must be able to perform CPR, if required.

Occupational Therapist will spend approximately 60-80% of time bending, stooping, kneeling, and reaching while working with occupational therapy patients.

Occupational Therapist will spend approximately 60-80% of time walking/standing.

For Support Activities:

Occupational Therapist may spend approximately 10-20% of time sitting at desk

or terminal entering data.

License/Certification/Registration:

Current Occupational Therapist State Licensure as required.

Current CPR certification