Utilization Review RN

CommonSpirit HealthPerth, Bremerton, Western Australia, WashingtonOn-siteFull-timeMid level, 2–5 yearsListed 1 hour ago

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About this role

Job Summary and Responsibilities

As a member of a multidisciplinary team, in a leadership role, is responsible for coordination of patient care along the full continuum and/or for a target population. Through intervention, promotes the appropriate utilization of resources, identifies and addresses care gaps, promotes health behavior changes for patients to better manage their illnesses and recovery (if not chronic), and analyses readmissions to the acute setting post hospitalization. As a result, optimal clinical, financial, functional and health status improvements in the target population will be accomplished.

Incumbents will use professional judgment, independent analysis and critical-thinking skills to apply clinical guidelines, policies, and regulatory requirements, etc. to determine the appropriate level of care.

Monitor's patient's clinical status and needs in order to ensure appropriate intensity of services and anticipate and prepare for transitions of care.

Interventions will be targeted towards effective management of each episode of care and the seamless transition to the next level of care.

The goal will be towards promoting patient engagement and participation in their care at their highest attainable level. The desired result is management of the patient in the least restrictive environment possible.

Incumbents are also accountable for demonstrating a strong commitment to promoting excellence every day by maintaining and demonstrating competent professional practice and engaging in opportunities for professional growth.

Job Requirements

Required:

Graduation from an accredited school of nursing, upon hire and

three (3) years of recent clinical work experience in the specialty area or related clinical specialty in a hospital setting within the past five (5) years that demonstrates attainment of the requisite job knowledge skills/abilities and

Registered Nurse: WA (RN:WA) upon hire and

Preferred:

Experience with utilization management, discharge planning and/or case management

Accredited Case Manager (ACM) upon hire preferred or

Case Management Nurse (RN-BC CASE) upon hire preferred or

Certified Case Manager (CCM) upon hire preferred or

Psychiatric and Mental Health Nurse (RN-BC PSY) upon hire preferred

Where You’ll Work

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.