Utilization Review Rn Jobs in Atlanta, GA (NOW HIRING)

We are seeking an Admissions RN to join our Lakeview Behavioral Health team!

AVAILABLE SHIFTS

• Full time - Night Shift (7p-7a).

SIGN-ON BONUS:

$10,000 Sign On Bonus!

Benefits:

At Lakeview Behavioral, we take care of our team’s needs. We provide a comprehensive package of benefits for our Registered Nurse team, including:

• Professional growth opportunity that is second to none in the industry.
• Work Life balance is as important to us as it is to you, and we strive to find that perfect fit.
• PerkSpot! Our employee discount program for over 30,000 merchants.
• 100% Paid Psychiatric Training!
• Excellent career advancement and cross training opportunities!

PURPOSE STATEMENT:

Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for patients and their benefit/resource utilization.

• Review medical documentation for all admissions, complete medication reconciliation, and obtain admission orders from physicians.
• Facilitate emergency transfers for patients presenting with emergency medical conditions outside of the facility’s capabilities.
• Review referrals from hospitals, facilities, and other community agencies for medical and behavioral acuity and respond within facility policy timeframes.
• Respond to inquiries about the facility and provide appropriate recommendations.
• Conduct assessments to determine the appropriate level of care within the facility.
• Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions.
• Facilitate admissions process for incoming patients including assessment, consent, and inventory of patient belongings.
• Perform insurance benefit verifications and secure initial pre-authorization for treatment and admission.
• Monitor patient status throughout the admissions process in accordance with facility policy and/or physician orders.
• Utilize multiple web-based programs to track and review referrals.
• Communicate projected admissions to designated internal representatives promptly.
• Ensure all clinical information from referral sources or patients (including medical comorbidity information) is received, when possible, prior to patient admission.
• Schedule (when applicable) and complete pre-admission assessments, consult with the admitting physician and communicate disposition recommendations to the patient or their family.
• Possess skill in preparing and maintaining appropriate medical record documentation that will result in authorization at the level of care being requested of the payor.
• Complete initial pre-authorization for treatment and admission prior to admission, when possible, and within payor timeframe guidelines.
• Admit the patient to the registration and accounting system. Complete all admission and consent forms with the patient.
• Demonstrate a positive, empathetic, and professional attitude toward customers always. When patient needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
• When a patient’s needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
• Coordinate care for patients who are not being admitted and ensure that they receive appropriate follow-up care and referrals.
• Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service.
• Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or in accordance with individualized supervision guidelines as needed.

OTHER FUNCTIONS:

• Perform other functions and tasks as assigned.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

• Minimum of Associate’s degree in Nursing.  

• Minimum one year of experience working with individuals in a clinical or observational capacity, preferably within the area of specialty for the hiring facility. 

LICENSES/DESIGNATIONS/CERTIFICATIONS: 

• Clear and active nursing license in the state. 

• CPR and de-escalation/restraint certification required (training available upon hire and offered by facility). 

• First aid may be required based on state or facility 

AHRN