DSHS OHBH Registered Nurse 2
Olympic Heritage Behavioral Health is inviting Registered Nurses to join our nursing team. Our nurses are devoted to compassionate patient care, have a strong work ethic, and display consistently good judgment. Our clients are people with serious and/or long-term behavioral health issues who count on us as they work toward healing and growth. From minor interactions to the countless efforts to promote recovery, we matter, we are needed, and we make a difference in our clients' lives.
Eligible employees receive an excellent benefits package that rivals any employer in Washington State, and all experience a rewarding career and exciting opportunities to learn and grow.
We value our remarkable nursing staff and understand how important they are to our patients, their families, and our facility. If you want to explore inpatient psychiatric nursing and seek to use both your mind and heart to support your patients on their road to recovery, come join our team! We offer a great learning environment, a rewarding career, and opportunities for advancement. Join us in Transforming Lives!
This is a M-F 8-4:30 position.
Some of what you'll do:
In this position you will maintain compliance with the Center for Medicare and Medicaid (CMS) regulations through proactive data analysis, utilization review, and case management. Works under Utilization Review Committee in development, revision of the guidelines of UM and provide education to treatment teams concerning proper utilization of hospital resources, treatment or services.
-
Conducts reviews: admission, concurrent, private insurance, Title 19, outlier, retrospective, retroactive, recidivism, no Primary diagnosis, recertification, decertification, focus, ready for discharge and other review as needed
-
Notify and communicate with different manage care agencies for authorization of patient admissions; provide clinical updates to managed care agencies for continued authorization
-
Coordinate the Annual Medical Care Evaluation (MCE) study as required by the code of Federal Regulation for the Utilization Management Committee (UMC) and prepare and present written and/or oral reports of MCE study to the UMC and other committees as required
-
Prepare agenda, reports for the UMC and be a facilitator and/or lead the UMC meeting
-
Ongoing education of professional staff and appropriate support staff regarding utilization management (UM) functions/requirements and appropriate level of care/utilization issues
-
Maintain ongoing statistical data regarding utilization and review of patients per payer source, length of stay
-
Monitor updated CMS regulation for UM and be subject matter expert
-
Monitor and update UM SharePoint
-
Record information received from the Office of Financial Recovery regarding financial eligibility for patients
-
Monitor UM program at WSH, identify UM problems and report to the UMC .
-
Active member of the UMC: assisting in the development and revision of the UM manual, policy and procedures
-
Generates charts, graphs, flowcharts, worksheets, booklets, brochures, and forms using appropriate software for the UM Department
-
Gathers information and prepares routine data summaries and narrative reports .
-
Analyzes compliance of patient certifications
-
Daily UM work assignment distribution
-
Provide non-certification letter to patients that do not meet medical necessity for continued inpatient hospitalization and recertification letters to patients that meet medical necessity and active treatment criteria after decertification, explaining reason for both decisions to the patient
-
Appealing to private insurance companies who deny payment by communicating with the insurance companies and mailing requested documentation for review
-
Offer suggestions to treatment team on efficient utilization of treatment modalities
What we're looking for:
Graduation from an accredited school of professional nursing
AND
One year of professional nursing experience. OR Equivalent education/experience
OR
Graduation from an accredited school of professional nursing and at least two years professional nursing experience OR equivalent education/experience
-
BSN or CPUR preferred, two years' experience in Utilization Review/Management or Case Management, medical terminology, clinical background in psychiatric nursing
-
Strong organizational and interpersonal skills
-
Abilities to determine appropriate course of action in more complex situations
-
Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude
-
Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work
-
Ability to complete work assignments accurately and in a timely manner
-
Ability to communicate effectively, both orally and in writing
-
Ability to handle difficult situations involving patients, physicians, or others in a professional manner
-
Ability to use Microsoft Office: excel, word, vista, PowerPoint and PDF
-
Must be able to speak/present reports in a large group/committee
Interested? Apply today.
Our Department of Social and Health Services (DSHS) mission to
Transform Lives requires that we come together with a sense of belonging, common purpose, shared values, and meaningful work. It is crucial to our agency’s mission that you bring equity, anti-racism, and social justice commitment to your work with DSHS. We strive to create greater access and affirming representation of the communities we serve, including Black, Indigenous, and People of Color, people with physical, behavioral health, and intellectual disabilities, elders, LGBTQIA+ individuals, immigrants and refugees, and families building financial security.
Questions? Please contact peter.bonato@dshs.wa.gov OR call (360) 725-5810 and reference job number 07090.
Prior to a new hire, a background check including criminal record history may be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the job. This announcement may be used to fill multiple vacancies. Employees driving on state business must have a valid driver's license. Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.
Washington State Department of Social and Health Services is an equal opportunity employer and does not discriminate in any area of employment, its programs or services on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protected veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information. Persons requiring accommodation in the application process or this job announcement in an alternative format may contact the Recruiter at (360) 725-5810. Applicants who are deaf or hard of hearing may call through Washington Relay Service by dialing 7-1-1 or 1-800-833-6384.
E-Verify® is a registered trademark of the U.S. Department of Homeland Security