Registered Nurse (RN) - Case Manager, Utilization Review
Surgery Partners
Durham, NC

FT-RN Case Management/Utilization Review Coordinator

North Carolina Specialty Hospital (NCSH), is a private, physician-owned medical center that opened its doors in 1926. North Carolina Specialty Hospital's commitment to growth and continuous improvement has helped the hospital maintain a number of high rankings in both quality measures and patient satisfaction. North Carolina Specialty Hospital offers surgical specialties in orthopedics, ophthalmology, ear, nose and throat as well as sports medicine, oral, plastic, podiatry, general surgery, interventional radiology, pain management, reconstructive surgery and more. Why join North Carolina Specialty Hospital? * Award Winning Hospital for Special Surgery * 5 Star CMS rated facility for patient experience * Positive Work culture * Career growth opportunities * Comprehensive Medical, Dental, Vision Insurance, Life and Disability Insurance * Telemedicine/You have access to Physicians 24/7/365 through MDLIVE * Paid Time Off * 401k Employer Match * Tuition Assistance Job Summary Under the direction of the Performance Outcomes Director, this position is responsible for coordinating patients in healthcare continuum to achieve optimal clinical, financial, operation and satisfaction outcomes. Act in a liaison function with the interdisciplinary healthcare team to promote and/or facilitate utilization of medical services. Identify and intervene when necessary to ensure efficient and cost-effective delivery of patient care services. Establish and promote collaborative relationships with physicians, patients, families and additional members of the healthcare team. Educate members of the healthcare team on utilization review and managed care concepts. Act as a resource for routine and complex problem solving as it relates to utilization review and case management. Anticipate the needs of customers and work proactively to improve services. Work with others to improve customer satisfaction and participates in special projects as needed. Training & Education * Graduate of an accredited school of professional nursing required. * Current licensure in the state of North Carolina required. * Current certification BLS * Must be able to communicate and understand the English language both verbal and written. Experience: * A minimum of 1 year previous Medical and/or Surgical nursing experience preferred. * Utilization Review and Case Management experience required. Skills & Abilities: * Able to work independently and meet established deadlines. * Able to make sound reasonable decisions. * Highly organized. * Ability to concentrate on many detailed requests. * Demonstrates accountability, professionalism, openness, receptive to change, creativity and innovative. * Ability to identify and calmly handle inherently stressful situation with tact. * Excellent communication skills * Ability to develop excellent working relationships with consumers and staff. * Seeks guidance, direction and assistance when needed. Our employees are critical to our success, and we value their contributions. North Carolina Specialty Hospital offers a competitive compensation and benefits package and an opportunity to grow and develop your career in an environment that values employee ideas and diversity. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled. We maintain a drug-free workplace and require pre-employment drug screening and background check.