Utilization review nurse jobs in Revere, MA - 511 jobs

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.This is a per diem position.Coordinates care for patients receiving treatment in a specialty service, including the evaluation, assessment, scheduling, consultation and treatment of patients in order to implement a seamless progression of care to meet the patient's needs.Key responsibilities of this role include: - Acts as a resource and consultant for the acute and rehabilitative care of patients with selective disorders of the integumentary, gastrointestinal and genitourinary system including complex draining wounds, ulcers, fistulae, tubes and ostomies. Evaluates patient progress toward expected outcomes, making changes in plan of care, as indicated. - Utilizes current national guidelines to participate in the development and implementation of procedures, protocols and education related to the care of these patients. - Offers outpatient services for ostomy and wound patients as requested by BIDMC physicians. When possible, preoperatively determines the appropriate site for stoma placement, considering patient's anatomical marking, physical capabilities and lifestyle. - Recommends standards for selection of cost-effective supplies and equipment for wound, ostomy and continence disorders to be utilized by the medical center. Standards should be based on product evaluations, product research studies and cost-effective comparisons. Collaborates with administration to establish protocols to address cost contained clinical benefits for patient care. - Participates in committees or task forces, as requested by employer to local national organization. Contributes to professional or consumer publications and supports associated organizations.WOCN certification preferred Job Description:Essential responsibilities including but not limited to: 1. Collaborates with physicians and other health care providers to coordinate the care for patients from referral/consultation to discharge /follow up. Assists with pre-authorization process.2. Serves as contact and facilitator to receive consults and patient information. Coordinates and ensures all patient scheduling including but not limited to consultation, diagnostic and treatment procedures.3. Gathers information for history and physical. Performs and documents evaluations and assessments of patient. Assists in ordering labs, x-rays, and diagnostic procedures.4. Works in collaboration with surgeons and physicians in educating the patients and their families in medical care. Assists in development of patient/family educational materials. Participates in patient rounds and case conferences.5. Updates clinical knowledge and skills through consultation, formal and informal education, and review of literature for self and clinical team. Provides leadership for process improvement related to the care of these patients.6. Makes and answers patient phone calls, both pre and post treatment/procedure, from patients referring providers, and outside facilities (hospitals, rehabilitation centers, physician offices).Required Qualifications:1. Associate's degree in Nursing required. Bachelor's degree in Nursing preferred.2. License Registered Nurse required., and Certificate 1 Basic Life Support required.3. 1-3 years related work experience required.4. American Heart Associate - Basic Life Support Certificate5. Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.Preferred Qualifications:1. Prior experience in specialty service preferred.Competencies:1. Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.2. Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues.3. Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction.4. Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.5. Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.6. Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.7. Teamwork: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.8. Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.Age based Competencies: Employees in this job must be competent to provide patient care to the following age groups: Neonatal:Birth to 6 months, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 - over.Social/Environmental Requirements:1. Work requires close attention to task for work to be accurately completed. Intermittent breaks during the work day do not compromise the work.2. Work is varied every day and the employee needs to be adaptable to respond to these changes and use independent judgment and manage priorities.3. Potential exposure to adverse environmental conditionso Daily: Protective equipment required(Respirator,earplugs,mask,gloves,eyewear etc), Potential exposure to infectious diseases and/or airborne pathogens, Potential exposure to infectious diseases and/or bloodborne pathogens.4. Health Care Status: HCW1: Regular, day-to-day contact; both face-to-face and hands-on (having close contact within three feet for at least five minutes). Examples: physicians, clinical nurses, phlebotomist, medical assistants, PFT tech, and x-ray tech.- Health Care Worker Status may vary by department Sensory Requirements:Close work (paperwork, visual examination), Color vision/perception, Visual monotony, Visual clarity > 20 feet, Visual clarity