Utilization Review Rn Jobs in Columbia, MO (NOW HIRING)

Job Type
Full-time
Description
Description
The primary responsibility of the Community Living Nurse is to assess medical needs regarding Woodhaven Individuals and respond to those needs. The Community Living Nurse works with community physicians and their nurses to maximize the effectiveness of the individuals supported care, orders, recommendations, etc. and ensures that Woodhaven staff understand those and incorporate them into the overall lifestyle of the individual served.
EXAMPLES OF JOB DUTIES/MARGINAL FUNCTIONS OF THE JOB:
1. Priority is completing face to face monthly nursing assessments in compliance with DMH guidelines and standards.
2. Review, analyze, and interpret lab results at least monthly.
3. Review Physician Orders for accuracy and staff compliance at least monthly.
4. Monthly medication reconciliation: review MAR for accuracy, compare to physician orders, note compliance, monitor side effects of medications and utilization of PRNs. Check for accurate storage, labeling, effectiveness, and supporting diagnosis for medications prescribed. Consult with MD, Pharmacist and other appropriate contacts to facilitate optimal health outcomes as related to prescribed pharmacological therapy and accuracy of MARs.
5. Monthly Health Records Review includes but is NOT limited to: Assessing vital signs, blood sugar, dietary, fluids, seizure, weight, immunization records, bowel activity, menses, skin, range of motion, event reports for falls, injuries, medication errors, medical appointments, hospitalization/ER reports, and significant changes in behavior.
6. Provide appropriate delegation and supervision of unlicensed support staff who perform such duties as medication administration and other nursing tasks when applicable and document these.
7. Complete RN Directives (recommendations for program enhancements) on each monthly assessment, whenever opportunities for service improvements are identified.
8. Timely and reimbursable documentation of monthly health assessment and separate billing note.
9. Managing assigned case load and providing support to Contract RN and other nursing colleagues to meet the Health Service needs of individuals served.
10. Become acquainted with individuals supported, staff and agency systems.
11. Provide direct nursing care when needed (catheter changes, suture removal, etc.)
12. Advise Assistant Director of Residential Services/Health Services, Director of Residential and Community Services, Program Manager and Home Coordinator of issues related to health and safety of individuals.
13. Assessment, nursing diagnosis, nursing care and counsel of persons who are ill, injured or experiencing alterations in normal health processes.
14. Share on-call responsibility within the health services department.
15. Employee in-services/training as needed.
16. Responsibility for the teaching of healthcare and prevention of illness to the individuals supported and his or her family.
17. The administration of medications and treatments as prescribed.
18. Ability to appropriately intervene with individuals who may display challenging and combative behaviors.
19. Recommends supports and services as needed.
20. Maintain confidentiality of each individual.
21. Serve as a member of HIPAA team. Assume and carry out assigned responsibilities pertaining to the protection and disclosures of private health care information (PHI).
22. Works in partnership with other area agencies for the best interest of individuals supported.
23. Monitor the application of all physician orders, including but not limited to treatments, procedures, labs, appointments, specialized diet and adaptive equipment for consumers. Applicant must ensure that physician orders are carried out or implemented based on the individual needs of the persons receiving services and in accordance with the DMH requirements.
24. Consults with Home Coordinators, Direct Support Professionals, Program Managers, Director of Residential and Community Services and personnel of other agencies, including other health care agencies emphasizing best practices in regard to our individuals.
25. The coordination and assistance in the delivery of a plan of care with all members of the health team.
26. Ensure that all services are in compliance with CARF standards and certification principles.
27. Assess employees who receive a work-related injury and refer them for appropriate medical follow up if necessary and provide the information to the Human Resource office immediately following the assessment.
STAFF ORIENTATION:
1. Visit homes and educate staff regarding healthcare issues.
2. Assist with medication classes as needed.
3. Work with Program Manager's and Home Coordinator's to resolve concerns addressed by CMRO RN's & Support Coordinators.
4. Assist with providing Healthcare Training for staff (CMA, Nutrition, choking, etc.)
Why Join Woodhaven
At Woodhaven, we believe the meaningful work of supporting others begins with supporting our own team. We are committed to creating a workplace where employees feel valued, encouraged, and equipped to grow. That commitment shows up in the way we invest in your well-being, your professional development, and your future-so you can continue making a difference in the lives of the individuals and communities we serve.

• Earn up to 4.5 weeks of paid time off as a full-time employee, with a PTO cash-out option for added flexibility.
• Build long-term financial security through Woodhaven's pension plan with a 3% employee contribution and an 11% employer contribution.
• Receive paid training for certifications and job-related development so you can feel confident and prepared in your role.
• Access performance-based bonus opportunities, including up to $500 quarterly bonuses for eligible positions and annual bonuses for professional roles.
• Earn up to $500 in referral bonuses for helping us grow a strong, mission-driven team.
• Explore tuition assistance opportunities if eligible, supporting your continued growth and career development.
• Use Rain Instant Pay for added flexibility and access to earned wages when needed.
• Choose from medical, vision, dental, and supplemental benefit options that support your overall well-being.
• Benefit from a Big Tree Medical Membership.
• Access 100% covered scans and many common surgeries through Valenz Health.
• Receive support through a free Employee Assistance Program (EAP) for employees and their families.
• Take advantage of pre-tax Healthcues benefits.
• Use Paytient with up to a $1,000 credit limit and 0% interest for eligible medical and veterinary expenses

Requirements
ESSENTIAL QUALIFICATIONS/FUNCTIONS OF THE POSITION:

• This position requires that you have a valid Missouri Registered Nurse license.
• Basic Computer skills
• Experience in Community Health Care or working with individuals with intellectual/developmental disabilities is preferred.
• Applicant must maintain a positive relationship with individuals they support.
• Applicant must have the ability to cooperate and work well with the individuals receiving services, their families and staff.
• The applicant must have a reliable personal vehicle and must be amenable to participating in the on-call rotation.

Essential Qualifications/Functions of the Position also include:

• Attendance/Ability to work flexible hours. Employees are expected to be reliable when reporting to work.
• Acceptance of supervision.
• Flexibility of schedule.

ESSENTIAL PHYSICAL REQUIREMENTS:
This is sedentary work requiring the exertion of up to 10 pounds of force occasionally and a negligible amount of force frequently or constantly to move objects; work requires fingering, grasping, and repetitive motions; vocal communication is required for expressing or exchanging ideas by means of the spoken word; hearing is required to perceive information at normal spoken word levels; visual acuity is required for preparing and analyzing written or computer data, operation of machines, determining the accuracy and thoroughness of work, and observing general surroundings and activities; the worker is not subject to adverse environmental conditions. Computer work requires a large amount of typing on a daily basis.
Salary Description
$66,560 -$72,800
Notice of AI Use in Job Application Review
As part of our commitment in creating a fair, efficient, and consistent hiring process we may use artificial intelligence (AI) to help our recruiting teams organize, summarize, and analyze information provided by candidates, including resumes, application responses, and other materials submitted during the application process.AI may be used to identify patterns, highlight relevant skills, and experience, and assist in comparing a candidate's qualifications with the requirement of a specific role. These tools are to improve efficiency and consistency while supporting more informed hiring decisions, which will ultimately be made by the hiring team.