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Registered Nurse Utilization Management Advisor - Gainesville, Florida - Manager

Company: Malcom Randall Department of Veterans Affairs Medi
Location: Gainesville
Posted on: January 15, 2022

Job Description:


The RN Utilization (UM) Advisor is a registered nurse responsible for UM reviews and use of InterQual, an evidence-based clinical decision product, for patients who receive hospital care. The UM Advisor demonstrates leadership in improving holistic care through collaboration with all disciplines and accurate data collection in National UM Integration (NUMI) software application. The Registered Nurse UM Advisor provides advice about inpatient care quality criteria, anticipates barriers to flow and transitions, and facilitates interdisciplinary team collaboration, admission through discharge.

Major duties include:

  • Provides evidence-based recommendations for level of care and evidence-based interventions based on InterQual coupled with reference to InterQual citations and other point of care resources
  • Reviews medical records and accurately documents UM reviews in NUMI following VACO UM process and then InterQual review process
  • Facilitates and coordinates admissions to the most appropriate level of care
  • Identifies patients with potential barriers to care and transition, collaborates with the interdisciplinary team (IDT) and participates in IDT rounds to facilitate early transition planning.
  • Uses InterQual and NUMI to provide recommendations about expected LOS, progress, care standards, and level of care for continued stay hospital days. Prepares reports as needed to address any outliers in LOS and patients with difficult discharge needs
  • Participates in interdisciplinary team meetings about anticipated barriers and discharge planning
  • Networks with Social Work, Inpatient Care Coordinators, and/or other community professionals to maintain knowledge of UM and transition planning
  • Learns, understands, and applies principles related to UM including practice guidelines, accreditation standards, and performance measures
  • Uses emergency and bed management software and utilization data to manage admission recommendations and identify barriers for the assigned patient population

    Work Schedule:

    Relocation/Recruitment Incentives:

    Financial Disclosure Report:

Keywords: Malcom Randall Department of Veterans Affairs Medi, Gainesville , Registered Nurse Utilization Management Advisor - Gainesville, Florida - Manager, Executive , Gainesville, Florida

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