Clinic Registered Nurse jobs at Yale New Haven Health - 179 jobs
Registered Nurse - YNHH
Yale New Haven Hospital 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
SUMMARY
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and ata to support our practice with the patient and family at the center, always.
The RN provides care that:
* Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice
* Includes communicating and working collaboratively with the patient, family and health care team members
* Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran.
Responsibilities
1. STANDARDS OF PRACTICE
RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation.
Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation.
Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues.
Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.
Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes.
Implementation: The RN implements the identified plan.
Coordination of Care: The RN coordinates care delivery and transitions in care.
Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment.
Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the rofessional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional
practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society.
Ethics: The RN practices ethically.
Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
Communication: The RN communicates effectively in all areas of practice
Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice.
Leadership: The RN leads within the professional practice setting and the profession.
Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.
Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice
Quality of Practice: The RN contributes to quality nursing practice.
Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice.
Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence -based nursing services that are safe, effective and fiscally responsible
Environmental Health: The RN practices in an environmentally safe and healthy manner
Qualifications
EDUCATION:
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current
BCLS certification or must obtain within one month of hire.
EXPERIENCE:
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
SPECIAL SKILLS: RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
ACCOUNTABILITY :
Accountable to practice within the Scope and Standards of Practice within the Nurse Practice Act of their state of
practice. RNs at YNHH are accountable to YNHHS standards of professional behavior. Nursing practice is overseen
by the Chief Nursing Officer (CNO) in each delivery network, and RNs are accountable to their chain of command . RNs are accountable to team members and upholding standards of professional behavior.
COMPLEXITY ):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Accountable to the Scope and Standards of practice noted in this job description.
LICENSURE/CERTIFICATION:
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly
encouraged.
$65k-98k yearly est. 20h ago
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RN - Women's Services YNHH
Yale New Haven Hospital 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran
Responsibilities
1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.
Qualifications
EDUCATION
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current BCLS certification or must obtain within one month of hire.
EXPERIENCE
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
LICENSURE
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly encouraged.
SPECIAL SKILLS
RegisteredNurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
PHYSICAL DEMAND
Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.
Additional Information
Openings available in Labor and Birth or Maternity.
New grads welcome to apply!
$65k-98k yearly est. 1d ago
Registered Nurse -Inpatient Surgery-New Grads Welcome to Apply!
Yale New Haven Hospital 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran
Responsibilities
1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.
Qualifications
EDUCATION
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current BCLS certification or must obtain within one month of hire.
EXPERIENCE
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
LICENSURE
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly encouraged.
SPECIAL SKILLS
RegisteredNurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
PHYSICAL DEMAND
Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.
Additional Information
YNHH Inpatient Surgery Units:
York Street Campus (YSC):
EP 6.5- Inpatient post-op recovery unit. The complex patient population is primarily colorectal and comprises a multitude of other services including plastic surgery, urology, trauma, emergency general surgery and orthopedics, as well as medicine.
EP 6.4- Surgical unit that has mixed acuity including both step down and floor level beds. The unit has the capacity to see a diverse population of surgical, orthopedic, neurology, neurosurgery, plastics, general surgery and trauma patients
Saint Raphael Campus (SRC):
Main 6- Specializing in bariatric, minimally invasive, and colo-rectal surgery. There is also exposure to medicine and general surgery overflow.
SLA 2- Surgical telemetry unit caring for both medicine and surgical populations including podiatry, vascular and general medicine overflow.
V3S- Diverse clinical population including urology, general surgery, OMF, ENT, plastics, vascular, and medicine overflow.
$65k-98k yearly est. 1d ago
RN - Ortho/Spine
Yale New Haven Hospital 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
EEO/AA/Disability/Veteran
Summary:
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes.
YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always.
The RN provides care that:
* Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice
* Includes communicating and working collaboratively with the patient, family and health care team members
* Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
Responsibilities
Responsibilities:
1. STANDARDS OF PRACTICE
RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation.
Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation
Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues.
Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.
Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes.
Implementation: The RN implements the identified plan.
Coordination of Care: The RN coordinates care delivery and transitions in care.
Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment.
Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society.
Ethics: The RN practices ethically.
Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
Communication: The RN communicates effectively in all areas of practice
Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice.
Leadership: The RN leads within the professional practice setting and the profession.
Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.
Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice.
Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice.
Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible
Environmental Health: The RN practices in an environmentally safe and healthy manner.
Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
N/A
LICENSURE
Valid State Of Connecticut RegisteredNurse License
SPECIAL SKILLS
BLS Required
Additional Information
Ortho/Spine Unit- Treats patients before and after surgery for total joint, hip, knees, shoulder, spinal fusion, fragility hip fractures, and joint infections.
$65k-98k yearly est. 1d ago
HVC Cardiac Care Nurse
Yale New Haven Hospital 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
SUMMARY
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and ata to support our practice with the patient and family at the center, always.
The RN provides care that:
* Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice
* Includes communicating and working collaboratively with the patient, family and health care team members
* Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran.
Responsibilities
1. STANDARDS OF PRACTICE
RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation.
Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation.
Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues.
Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.
Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes.
Implementation: The RN implements the identified plan.
Coordination of Care: The RN coordinates care delivery and transitions in care.
Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment.
Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the rofessional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional
practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society.
Ethics: The RN practices ethically.
Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
Communication: The RN communicates effectively in all areas of practice
Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice.
Leadership: The RN leads within the professional practice setting and the profession.
Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.
Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice
Quality of Practice: The RN contributes to quality nursing practice.
Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice.
Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence -based nursing services that are safe, effective and fiscally responsible
Environmental Health: The RN practices in an environmentally safe and healthy manner
Qualifications
EDUCATION:
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current
BCLS certification or must obtain within one month of hire.
EXPERIENCE:
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
SPECIAL SKILLS: RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
ACCOUNTABILITY :
Accountable to practice within the Scope and Standards of Practice within the Nurse Practice Act of their state of
practice. RNs at YNHH are accountable to YNHHS standards of professional behavior. Nursing practice is overseen
by the Chief Nursing Officer (CNO) in each delivery network, and RNs are accountable to their chain of command . RNs are accountable to team members and upholding standards of professional behavior.
COMPLEXITY ):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Accountable to the Scope and Standards of practice noted in this job description.
LICENSURE/CERTIFICATION:
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly
encouraged.
$64k-84k yearly est. 1d ago
HVC Vascular Nurse
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
SUMMARY
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and ata to support our practice with the patient and family at the center, always.
The RN provides care that:
Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice
Includes communicating and working collaboratively with the patient, family and health care team members
Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran.
Responsibilities
1. STANDARDS OF PRACTICE
RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation.
Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation.
Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues.
Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.
Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes.
Implementation: The RN implements the identified plan.
Coordination of Care: The RN coordinates care delivery and transitions in care.
Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment.
Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the rofessional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional
practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society.
Ethics: The RN practices ethically.
Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
Communication: The RN communicates effectively in all areas of practice
Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice.
Leadership: The RN leads within the professional practice setting and the profession.
Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.
Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice
Quality of Practice: The RN contributes to quality nursing practice.
Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice.
Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence -based nursing services that are safe, effective and fiscally responsible
Environmental Health: The RN practices in an environmentally safe and healthy manner
Qualifications
EDUCATION:
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current
BCLS certification or must obtain within one month of hire.
EXPERIENCE:
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
SPECIAL SKILLS: RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
ACCOUNTABILITY :
Accountable to practice within the Scope and Standards of Practice within the Nurse Practice Act of their state of
practice. RNs at YNHH are accountable to YNHHS standards of professional behavior. Nursing practice is overseen
by the Chief Nursing Officer (CNO) in each delivery network, and RNs are accountable to their chain of command . RNs are accountable to team members and upholding standards of professional behavior.
COMPLEXITY ):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Accountable to the Scope and Standards of practice noted in this job description.
LICENSURE/CERTIFICATION:
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly
encouraged.
$63k-78k yearly est. 1d ago
Registered Nurse (RN), Float Critical Care / ICU
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The RegisteredNurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
Functions As A Preceptor To New Staff.
Functions As A Charge Nurse.
Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
Demonstrates Competency In The Care Of The Neuro Patient
Demonstrates Skill And Knowledge In Neuro Assessment
Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
Demonstrates Skill And Understanding In Caring For A Trached Patient
Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator
Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
1 Year NNICU RN experience required.
LICENSURE
Valid State Of Connecticut RegisteredNurse License
SPECIAL SKILLS
BLS Required
$83k-109k yearly est. 1d ago
Registered Nurse (RN) - ICU
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The RegisteredNurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
Functions As A Preceptor To New Staff.
Functions As A Charge Nurse.
Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
Demonstrates Competency In The Care Of The Neuro Patient
Demonstrates Skill And Knowledge In Neuro Assessment
Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
Demonstrates Skill And Understanding In Caring For A Trached Patient
Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator
Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
1 Year acute nursing experience required.
LICENSURE
Valid State Of Connecticut RegisteredNurse License
SPECIAL SKILLS
BLS Required
Additional Information
1 Year Acute RN Experience Required. Critical Care or Emergency experience preferred.
$83k-109k yearly est. 1d ago
Medical-Surgical Registered Nurse (Med-Surg RN)
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The RegisteredNurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
Functions As A Preceptor To New Staff.
Functions As A Charge Nurse.
Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
Demonstrates Competency In The Care Of The Neuro Patient
Demonstrates Skill And Knowledge In Neuro Assessment
Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
Demonstrates Skill And Understanding In Caring For A Trached Patient
Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator
Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
N/A
LICENSURE
Valid State Of Connecticut RegisteredNurse License
SPECIAL SKILLS
BLS Required
$77k-103k yearly est. 1d ago
RN - MICU YSC
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The RegisteredNurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
Functions As A Preceptor To New Staff.
Functions As A Charge Nurse.
Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
Demonstrates Competency In The Care Of The Neuro Patient
Demonstrates Skill And Knowledge In Neuro Assessment
Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
Demonstrates Skill And Understanding In Caring For A Trached Patient
Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator
Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
1 Year acute nursing experience required.
LICENSURE
Valid State Of Connecticut RegisteredNurse License
SPECIAL SKILLS
BLS Required
Additional Information
1 Year Acute RN Experience Required. Critical Care or Emergency experience preferred.
$65k-98k yearly est. 1d ago
HVC Cardiac Telemetry Nurse
Yale New Haven Health 4.1
Clinic registered nurse job at Yale New Haven Health
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
SUMMARY
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registerednurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and ata to support our practice with the patient and family at the center, always.
The RN provides care that:
Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice
Includes communicating and working collaboratively with the patient, family and health care team members
Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran.
Responsibilities
1. STANDARDS OF PRACTICE
RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation.
Assessment: The registerednurse collects pertinent data and information relative to the healthcare consumer's health or situation.
Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues.
Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.
Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes.
Implementation: The RN implements the identified plan.
Coordination of Care: The RN coordinates care delivery and transitions in care.
Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment.
Evaluation: The RN evaluates progress toward attainment of outcomes.
2. STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the rofessional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional
practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society.
Ethics: The RN practices ethically.
Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
Communication: The RN communicates effectively in all areas of practice
Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice.
Leadership: The RN leads within the professional practice setting and the profession.
Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.
Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice
Quality of Practice: The RN contributes to quality nursing practice.
Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice.
Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence -based nursing services that are safe, effective and fiscally responsible
Environmental Health: The RN practices in an environmentally safe and healthy manner
Qualifications
EDUCATION:
Graduation from an accredited school of nursing. BSN preferred. All newly hired registerednurses must have current
BCLS certification or must obtain within one month of hire.
EXPERIENCE:
RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
SPECIAL SKILLS: RegisteredNurse is the foundational for all RNs. All RNs are encouraged to advance through the
SPIRE clinical advancement program.
ACCOUNTABILITY :
Accountable to practice within the Scope and Standards of Practice within the Nurse Practice Act of their state of
practice. RNs at YNHH are accountable to YNHHS standards of professional behavior. Nursing practice is overseen
by the Chief Nursing Officer (CNO) in each delivery network, and RNs are accountable to their chain of command . RNs are accountable to team members and upholding standards of professional behavior.
COMPLEXITY ):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Accountable to the Scope and Standards of practice noted in this job description.
LICENSURE/CERTIFICATION:
Licensed and a currently registerednurse in the State of Connecticut. Clinical specialty certification highly
encouraged.
at Nuvance Health
FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIREDHybrid/RemoteSummary:The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours and that ongoing communication (electronic and telephonic) with payers ensures timely approval of all hospital days, preventing delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and deny claims and escalating any egregious payer behaviors to internal leadership for assistance in resolution. Responsibilities:
Review all inpatient admission and observation cases using InterQual, or Milliman Care Guidelines or CMS 2 Midnight Rule (depending on payer) within 12-24 hours of admission, seven days a week for assigned shifts.
Complete an initial screening review within the first few hours of decision to admit from ED and communicate with appropriate Provider if initial status is to be re-considered.
Identify incomplete clinical reviews in work queues and complete them within two hours whenever possible. If clinical information is not available by the time the lack of a review may result in a denial, escalate to the appropriate Provider/VPMA.
Identify and complete clinical reviews required for submission to specific payers.
Validate admission orders for all new admits/observations/outpatients daily.
Ensure that the patient status order documented in the chart aligns with the MCG and/or InterQual criteria, or the CMS Two- Midnight Rule, to support the appropriate status and level of care.
Prioritize review of all outpatient observation and outpatient bedded cases at least every 8 hours for conversion to inpatient status or discharge opportunities.
Participate in daily Observation Huddles.
Conduct concurrent reviews for all payers daily for the first three days of admission, then every 2-3 days, or more frequently if criteria are waning.
Submit concurrent reviews to payers to ensure authorization of all days for per diem and percentage of charge reimbursement payers.
If concurrent inpatient case does not meet medical necessity review criteria during the first level review, discuss with the attending MD to obtain additional clinical information and documentation to support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review.
Forward cases that require secondary physician review to appropriate resource (e.g., Physician Advisor).
Resolve any discrepancy at the time of review. If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership.
Coordinate with the care team in changing patient status, as needed. ï ½ Notify the care team when patient does not meet medical necessity per InterQual or MCG guidelines or 2 MN Rule and escalate appropriately.
Document and proactively communicate relevant clinical information to payers for authorizations for treatments, procedures, and Length of Stay ï ½ submit clinical information as required by payers.
Ensure completion and delivery of required patient notices (by onsite team member). These include but are not limited to: HINNs, Condition Code 44, MOON, Connecticut notice of conversion, etc.
Tracking and trending all appeals and communicating on a daily/regular basis with the Denials Management team.
Assists with informing Managed Care contracting team with necessary contractual language to protect organization financial position specific to inpatient medical necessity requirements.
Employs creative solutions with team members and leadership to prevent denials.
Performs other duties as assigned.
Other Information:Education Skills Experience
Bachelor's Degree (BSN) is highly preferred.
Minimum of Associate's Degree in Nursing required when accompanied by strong demonstrated competencies and significant experience.
Minimum of 5 years experience in acute care Nursing
Proficiency in Milliman and InterQual Guidelines required
Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4 years experience required for Associate's Degreed individuals.
PREFER: Master's Degree in related field
Required: Current RN License in Connecticut and New York
InterQual/MCG proficiency testing completed (preferred); required within 1 year of hire. As certification becomes available, requirement will be revisited.
Knowledge of regulatory requirements for CMS
Have the positive attitude and aptitude to adapt to the continuing change in payer behaviors
Recognizes that education is the responsibility of the individual as well as the organization
Seeks external knowledge on payers (such as free email services as Becker's)
Must have analytical abilities to assist in obtaining solutions to problems
Self-starter and highly motivated
Must be able to work independently in a fast-paced environment, manage workload and prioritize work
Must be able to manage multiple competing priorities and maintain calm professional demeanor during peak demand
Must possess a high degree of prioritization skills
Exceptional interpersonal skills to effectively communicate with the physicians, payers, and other members of the interdisciplinary care team
Current working knowledge of utilization management, performance improvement and managed care reimbursement.
Working Conditions:Manual: Some manual skills/motor coord & finger dexterity Occupational: Little or no potential for occupational risk Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force Physical Environment: Generally pleasant working conditions Company: Nuvance HealthOrg Unit: 2092Department: Care CoordinationExempt: YesSalary Range: $45.29 - $84.11 Hourly
$28k-52k yearly est. Auto-Apply 2h ago
RN (Registered Nurse) Medical Practice Clinical Lead-Nephrology department- Danbury, CT
Nuvance Health 4.7
Danbury, CT jobs
***$7,500 - Sign-On Bonus for Full-time externals only, pro-rated for Part-time*** * in the Nephrology department in Danbury, CT* *40 hours per week, Monday-Friday, 8 hour variable shifts between 730am-6:00pm.*Summary:
The Clinical Lead RN works with the clinical staff, physicians and advanced practitioners in the coordination of assigned staff, equipment and resources to facilitate smooth daily operational flow. They optimize patient care and direct and assist the assigned staff in their daily work processes. Span of Control to include RN's, LPN's and potentially MA's (Dependent on Practice Structure).
Responsibilities:
* Patient check-in, document chief complaint, vital signs, history, capture charges for provision of ancillary services, assists with the completion of patient summaries, medication/allergy, history forms, and obtain appropriate treatment consents.
* Administer and document injections, dispense and document medications as directed by physician/provider. Label and handle labs, paps, cultures, biopsies and other specimens, prepare laboratory and imaging requisitions.
* Assist with coordination of further patient care and follow-up and carry out tasks as directed by RN and/or physician/provider. This may include communication with patient, hospital, labs, imaging centers, pharmacies, physician offices, insurance plans.
* Independently manages patient triage calls and seeks out direction from providers as needed. Assists LPN's and MA's with triage disposition and assures documentation is reflective of the disposition.
* Measures and monitors key performance indicators (KPIs) in conjunction with the Practice Leadership. KPIs include Growth/Financial Stability, Patient Experience, Operational Efficiency, Employee Satisfaction/Culture, Quality
* Demonstrates clinical expertise and serves as a resource for the clinical staff.
* Monitors inventory and orders medical supplies as requested by physicians as well as follow up on all outstanding orders.
* Responsible for managing PTO requests and maintaining appropriate staff and provider schedules and levels.
* Develops guidelines for prioritizing work activities, evaluates the effectiveness and modifies activities as necessary.
* In collaboration with Medical Practice Nursing Education, mentors, orients, trains, educates and supervises clinical staff to improve competency and patient satisfaction using established workflows and policies.
* Works in conjunction with Practice Manager, Medical Practice Nursing Leader and Human Resources for hiring, discipline, grievance management, performance evaluations, feedback and coaching to achieve optimal team performance.
* Monitors all clinical workflows of office, addressing inefficiency of providers and clinical staff and formulates corrective action plans to achieve KPI's.
* Holds monthly clinical meetings with providers and staff to review clinical KPI and implement/monitor process improvement plan.
* Utilizes patient satisfaction data to create targeted improvement plans.
* Escalates issues and concerns proactively to Manager, or clinic practice Leadership, as needed.
* Performs other duties as assigned.
Other Information:
* Graduate from approved nursing program
* Three (3) years nursing experience
* Prefer: Bachelor's Degree in Nursing (BSN)
* Graduation from accredited nursing program
* Able to multitask in fast paced environment
* Valid RN License (CT or NY based on Practice Location)
* Basic Life Support (BLS)
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Some occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health Med Practice CT
Org Unit: 520
Department: DB Nephrology
Exempt: No
Salary Range: $33.66 - $67.05 Hourly
We are an equal opportunity employer
Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at ************ (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.
*FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/Remote* * The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours and that ongoing communication (electronic and telephonic) with payers ensures timely approval of all hospital days, preventing delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and deny claims and escalating any egregious payer behaviors to internal leadership for assistance in resolution.
*Responsibilities:*
* Review all inpatient admission and observation cases using InterQual, or Milliman Care Guidelines or CMS 2 Midnight Rule (depending on payer) within 12-24 hours of admission, seven days a week for assigned shifts.
* Complete an initial screening review within the first few hours of decision to admit from ED and communicate with appropriate Provider if initial status is to be re-considered.
* Identify incomplete clinical reviews in work queues and complete them within two hours whenever possible. If clinical information is not available by the time the lack of a review may result in a denial, escalate to the appropriate Provider/VPMA.
* Identify and complete clinical reviews required for submission to specific payers.
* Validate admission orders for all new admits/observations/outpatients daily.
* Ensure that the patient status order documented in the chart aligns with the MCG and/or InterQual criteria, or the CMS Two- Midnight Rule, to support the appropriate status and level of care.
* Prioritize review of all outpatient observation and outpatient bedded cases at least every 8 hours for conversion to inpatient status or discharge opportunities.
* Participate in daily Observation Huddles.
* Conduct concurrent reviews for all payers daily for the first three days of admission, then every 2-3 days, or more frequently if criteria are waning.
* Submit concurrent reviews to payers to ensure authorization of all days for per diem and percentage of charge reimbursement payers.
* If concurrent inpatient case does not meet medical necessity review criteria during the first level review, discuss with the attending MD to obtain additional clinical information and documentation to support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review.
* Forward cases that require secondary physician review to appropriate resource (e.g., Physician Advisor).
* Resolve any discrepancy at the time of review. If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership.
* Coordinate with the care team in changing patient status, as needed. Notify the care team when patient does not meet medical necessity per InterQual or MCG guidelines or 2 MN Rule and escalate appropriately.
* Document and proactively communicate relevant clinical information to payers for authorizations for treatments, procedures, and Length of Stay submit clinical information as required by payers.
* Ensure completion and delivery of required patient notices (by onsite team member). These include but are not limited to: HINNs, Condition Code 44, MOON, Connecticut notice of conversion, etc.
* Tracking and trending all appeals and communicating on a daily/regular basis with the Denials Management team.
* Assists with informing Managed Care contracting team with necessary contractual language to protect organization financial position specific to inpatient medical necessity requirements.
* Employs creative solutions with team members and leadership to prevent denials.
* Performs other duties as assigned.
*Other Information:*
*Education Skills Experience*
* Bachelor's Degree (BSN) is highly preferred.
* Minimum of Associate's Degree in Nursing required when accompanied by strong demonstrated competencies and significant experience.
* Minimum of 5 years experience in acute care Nursing
* Proficiency in Milliman and InterQual Guidelines required
* Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4 years experience required for Associate's Degreed individuals.
* PREFER: Master's Degree in related field
* *Required:* Current RN License in Connecticut and New York
* InterQual/MCG proficiency testing completed (preferred); required within 1 year of hire. As certification becomes available, requirement will be revisited.
* Knowledge of regulatory requirements for CMS
* Have the positive attitude and aptitude to adapt to the continuing change in payer behaviors
* Recognizes that education is the responsibility of the individual as well as the organization
* Seeks external knowledge on payers (such as free email services as Becker's)
* Must have analytical abilities to assist in obtaining solutions to problems
* Self-starter and highly motivated
* Must be able to work independently in a fast-paced environment, manage workload and prioritize work
* Must be able to manage multiple competing priorities and maintain calm professional demeanor during peak demand
* Must possess a high degree of prioritization skills
* Exceptional interpersonal skills to effectively communicate with the physicians, payers, and other members of the interdisciplinary care team
* Current working knowledge of utilization management, performance improvement and managed care reimbursement.
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health
Org Unit: 2092
Department: Care Coordination
Exempt: Yes
Salary Range: $45.29 - $84.11 Hourly
We are an equal opportunity employer
Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at ************ (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.
$30k-54k yearly est. 60d+ ago
RN Clinical Case Coordinator-Thoracic Surgery department -Danbury, CT
Nuvance Health 4.7
Danbury, CT jobs
at Nuvance Health Med Practice CT
in the Thoracic Surgery department
covering the offices in Danbury, CT and Norwalk, CT.
Full Time, 40 hours per week, Monday-Friday between 8:00am-5:00pm.
Summary:
The RN Clinical Case Coordinator-Patient Navigator assists cancer patients and their families in maintaining the continuum of care by utilizing internal and community-based resources. Collaborates with other members of the interdisciplinary healthcare team to provide uninterrupted and integrated medical, financial, psychosocial, and vocational care of the patient in accordance with the patient's wishes, through a process of assessment, planning, implementation, and evaluation.
Responsibilities:
1. Conducts case findings. Screens cancer patients to identify support, education, discharge planning & referral. Comprehensive assessment of patient's physical, functional, psychosocial & financial status in cooperation with the health care team.
2. Develops, implements, and evaluates the plan of care and support through an interdisciplinary process in conjunction with the patient and family, linking the patient to appropriate institutional or community resources.
3. Procures services; serves as an advocate for patients and families with scarce resources. Facilitates referrals to state and local financial assistance agencies or programs.
4. Functions as a liaison between the hospital, physicians, patient, and community resources to achieve maximum communication between all parties so that care is coordinated and all needs of the patient are met.
5. Identifies quality issues related to cancer diagnosis, treatment and follow-up, risk management issues, and reimbursement issues with prompt referral to appropriate committee/personnel for action or resolution.
6. Assesses and evaluates cancer care through interaction with patients and surveys, and implements quality improvement projects as needed.
7. Serves as a representative of the cancer program/service line and lead person for coordination of care for patients.
8. Representing the cancer program provides education through health fairs and presentations to the community.
9. Supervises the volunteers within the cancer program, assuring compliance with appropriate patient interaction and confidentiality of information.
10. Participates as a member of the Cancer Committee; achieves the organization's established expectations with regard to customer service, teamwork, safety, and self-development.
11. Fulfills all compliance responsibilities related to the position.
12. Performs other duties as assigned.
Other Information:
Required: RN License. Experience in oncology nursing/case management. Excellent verbal and written skills, ability to conduct education programs.
Minimum Experience: five years
Oncology certification or eligible. Candidate will be expected to have taken the GW Navigation program training, and if not, it will be expected within the first 6 months of employment.
Education Requirement: Bachelor's preferred, Associates.
Desired: Certification in Case Management and Oncology nursing.
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health Med Practice CT
Org Unit: 583
Department: DB Thoracic Surgery
Exempt: Yes
Salary Range: $45.93 - $85.29 Hourly
$30k-54k yearly est. Auto-Apply 29d ago
RN (Registered Nurse) Medical Practice Clinical Lead-Nephrology department- Danbury, CT
Nuvance Health 4.7
Danbury, CT jobs
at Nuvance Health Med Practice CT
***$7,500 - Sign-On Bonus for Full-time externals only, pro-rated for Part-time***Medical Practice Clinical Lead RN position in the Nephrology department in Danbury, CT 40 hours per week, Monday-Friday, 8 hour variable shifts between 730am-6:00pm.
Summary:
The Clinical Lead RN works with the clinical staff, physicians and advanced practitioners in the coordination of assigned staff, equipment and resources to facilitate smooth daily operational flow. They optimize patient care and direct and assist the assigned staff in their daily work processes. Span of Control to include RN's, LPN's and potentially MA's (Dependent on Practice Structure). Responsibilities:
Patient check-in, document chief complaint, vital signs, history, capture charges for provision of ancillary services, assists with the completion of patient summaries, medication/allergy, history forms, and obtain appropriate treatment consents.
Administer and document injections, dispense and document medications as directed by physician/provider. Label and handle labs, paps, cultures, biopsies and other specimens, prepare laboratory and imaging requisitions.
Assist with coordination of further patient care and follow-up and carry out tasks as directed by RN and/or physician/provider. This may include communication with patient, hospital, labs, imaging centers, pharmacies, physician offices, insurance plans.
Independently manages patient triage calls and seeks out direction from providers as needed. Assists LPN's and MA's with triage disposition and assures documentation is reflective of the disposition.
Measures and monitors key performance indicators (KPIs) in conjunction with the Practice Leadership. KPIs include Growth/Financial Stability, Patient Experience, Operational Efficiency, Employee Satisfaction/Culture, Quality
Demonstrates clinical expertise and serves as a resource for the clinical staff.
Monitors inventory and orders medical supplies as requested by physicians as well as follow up on all outstanding orders.
Responsible for managing PTO requests and maintaining appropriate staff and provider schedules and levels.
Develops guidelines for prioritizing work activities, evaluates the effectiveness and modifies activities as necessary.
In collaboration with Medical Practice Nursing Education, mentors, orients, trains, educates and supervises clinical staff to improve competency and patient satisfaction using established workflows and policies.
Works in conjunction with Practice Manager, Medical Practice Nursing Leader and Human Resources for hiring, discipline, grievance management, performance evaluations, feedback and coaching to achieve optimal team performance.
Monitors all clinical workflows of office, addressing inefficiency of providers and clinical staff and formulates corrective action plans to achieve KPI's.
Holds monthly clinical meetings with providers and staff to review clinical KPI and implement/monitor process improvement plan.
Utilizes patient satisfaction data to create targeted improvement plans.
Escalates issues and concerns proactively to Manager, or clinic practice Leadership, as needed.
Performs other duties as assigned.
Other Information:
Graduate from approved nursing program
Three (3) years nursing experience
Prefer: Bachelor's Degree in Nursing (BSN)
Graduation from accredited nursing program
Able to multitask in fast paced environment
Valid RN License (CT or NY based on Practice Location)
Basic Life Support (BLS)
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Some occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health Med Practice CT
Org Unit: 520
Department: DB Nephrology
Exempt: No
Salary Range: $33.66 - $67.05 Hourly
$30k-54k yearly est. Auto-Apply 60d+ ago
RN Clinical Case Coordinator-Thoracic Surgery department -Danbury, CT
Nuvance Health 4.7
Danbury, CT jobs
in the Thoracic Surgery department covering the offices in Danbury, CT and Norwalk, CT. Full Time, 40 hours per week, Monday-Friday between 8:00am-5:00pm. The RN Clinical Case Coordinator-Patient Navigator assists cancer patients and their families in maintaining the continuum of care by utilizing internal and community-based resources. Collaborates with other members of the interdisciplinary healthcare team to provide uninterrupted and integrated medical, financial, psychosocial, and vocational care of the patient in accordance with the patient's wishes, through a process of assessment, planning, implementation, and evaluation.
Responsibilities:
1. Conducts case findings. Screens cancer patients to identify support, education, discharge planning & referral. Comprehensive assessment of patient's physical, functional, psychosocial & financial status in cooperation with the health care team.
2. Develops, implements, and evaluates the plan of care and support through an interdisciplinary process in conjunction with the patient and family, linking the patient to appropriate institutional or community resources.
3. Procures services; serves as an advocate for patients and families with scarce resources. Facilitates referrals to state and local financial assistance agencies or programs.
4. Functions as a liaison between the hospital, physicians, patient, and community resources to achieve maximum communication between all parties so that care is coordinated and all needs of the patient are met.
5. Identifies quality issues related to cancer diagnosis, treatment and follow-up, risk management issues, and reimbursement issues with prompt referral to appropriate committee/personnel for action or resolution.
6. Assesses and evaluates cancer care through interaction with patients and surveys, and implements quality improvement projects as needed.
7. Serves as a representative of the cancer program/service line and lead person for coordination of care for patients.
8. Representing the cancer program provides education through health fairs and presentations to the community.
9. Supervises the volunteers within the cancer program, assuring compliance with appropriate patient interaction and confidentiality of information.
10. Participates as a member of the Cancer Committee; achieves the organization's established expectations with regard to customer service, teamwork, safety, and self-development.
11. Fulfills all compliance responsibilities related to the position.
12. Performs other duties as assigned.
Other Information:
Required: RN License. Experience in oncology nursing/case management. Excellent verbal and written skills, ability to conduct education programs.
Minimum Experience: five years
Oncology certification or eligible. Candidate will be expected to have taken the GW Navigation program training, and if not, it will be expected within the first 6 months of employment.
Education Requirement: Bachelor's preferred, Associates.
Desired: Certification in Case Management and Oncology nursing.
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health Med Practice CT
Org Unit: 583
Department: DB Thoracic Surgery
Exempt: Yes
Salary Range: $45.93 - $85.29 Hourly
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$30k-54k yearly est. 30d ago
Clinical Denials Prevention & Appeals Specialist RN Per Diem
Nuvance Health 4.7
Danbury, CT jobs
The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours and that ongoing communication (electronic and telephonic) with payers ensures timely approval of all hospital days, preventing delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and deny claims and escalating any egregious payer behaviors to internal leadership for assistance in resolution
Responsibilities:
* Review all inpatient admission and observation cases using InterQual, or Milliman Care Guidelines or CMS 2 Midnight Rule (depending on payer) within 12-24 hours of admission, seven days a week for assigned shifts.
* Complete an initial screening review within the first few hours of decision to admit from ED and communicate with appropriate Provider if initial status is to be re-considered.
* Identify incomplete clinical reviews in work queues and complete them within two hours whenever possible. If clinical information is not available by the time the lack of a review may result in a denial, escalate to the appropriate Provider/VPMA.
* Identify and complete clinical reviews required for submission to specific payers.
* Validate admission orders for all new admits/observations/outpatients daily.
* Ensure that the patient status order documented in the chart aligns with the MCG and/or InterQual criteria, or the CMS Two- Midnight Rule, to support the appropriate status and level of care.
* Prioritize review of all outpatient observation and outpatient bedded cases at least every 8 hours for conversion to inpatient status or discharge opportunities.
* Participate in daily Observation Huddles.
* Conduct concurrent reviews for all payers daily for the first three days of admission, then every 2-3 days, or more frequently if criteria are waning.
* Submit concurrent reviews to payers to ensure authorization of all days for per diem and percentage of charge reimbursement payers.
* If concurrent inpatient case does not meet medical necessity review criteria during the first level review, discuss with the attending MD to obtain additional clinical information and documentation to support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review.
* Forward cases that require secondary physician review to appropriate resource (e.g., Physician Advisor).
* Resolve any discrepancy at the time of review. If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership.
* Coordinate with the care team in changing patient status, as needed. Notify the care team when patient does not meet medical necessity per InterQual or MCG guidelines or 2 MN Rule and escalate appropriately.
* Document and proactively communicate relevant clinical information to payers for authorizations for treatments, procedures, and Length of Stay submit clinical information as required by payers.
* Ensure completion and delivery of required patient notices (by onsite team member). These include but are not limited to: HINNs, Condition Code 44, MOON, Connecticut notice of conversion, etc.
* Tracking and trending all appeals and communicating on a daily/regular basis with the Denials Management team.
* Assists with informing Managed Care contracting team with necessary contractual language to protect organization financial position specific to inpatient medical necessity requirements.
* Employs creative solutions with team members and leadership to prevent denials.
* Performs other duties as assigned.
Education Skills Experience
* Bachelor's Degree (BSN) is highly preferred. Minimum of Associate's Degree in Nursing required when accompanied by strong demonstrated competencies and significant experience.
* Minimum of 5 years experience in acute care Nursing
* Proficiency in Milliman and InterQual Guidelines required
* Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4 years experience required for Associate's Degreed individuals.
* PREFER: Master's Degree in related field
* Current RN License in Connecticut and New York
* InterQual/MCG proficiency testing completed (preferred); required within 1 year of hire. As certification becomes available, requirement will be revisited.
* Knowledge of regulatory requirements for CMS
* Have the positive attitude and aptitude to adapt to the continuing change in payer behaviors
* Recognizes that education is the responsibility of the individual as well as the organization
* Seeks external knowledge on payers (such as free email services as Becker's)
* Must have analytical abilities to assist in obtaining solutions to problems
* Self-starter and highly motivated
* Must be able to work independently in a fast-paced environment, manage workload and prioritize work
* Must be able to manage multiple competing priorities and maintain calm professional demeanor during peak demand
* Must possess a high degree of prioritization skills
* Exceptional interpersonal skills to effectively communicate with the physicians, payers, and other members of the interdisciplinary care team
* Current working knowledge of utilization management, performance improvement and managed care reimbursement.
Education: BACHELOR'S LVL DGRE
Working Conditions:
Manual: Little or no manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health
Org Unit: 2092
Department: Care Coordination
Exempt: No
Salary Range: $65/hour
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FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED Hybrid/Remote The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours and that ongoing communication (electronic and telephonic) with payers ensures timely approval of all hospital days, preventing delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and deny claims and escalating any egregious payer behaviors to internal leadership for assistance in resolution.
Responsibilities:
* Review all inpatient admission and observation cases using InterQual, or Milliman Care Guidelines or CMS 2 Midnight Rule (depending on payer) within 12-24 hours of admission, seven days a week for assigned shifts.
* Complete an initial screening review within the first few hours of decision to admit from ED and communicate with appropriate Provider if initial status is to be re-considered.
* Identify incomplete clinical reviews in work queues and complete them within two hours whenever possible. If clinical information is not available by the time the lack of a review may result in a denial, escalate to the appropriate Provider/VPMA.
* Identify and complete clinical reviews required for submission to specific payers.
* Validate admission orders for all new admits/observations/outpatients daily.
* Ensure that the patient status order documented in the chart aligns with the MCG and/or InterQual criteria, or the CMS Two- Midnight Rule, to support the appropriate status and level of care.
* Prioritize review of all outpatient observation and outpatient bedded cases at least every 8 hours for conversion to inpatient status or discharge opportunities.
* Participate in daily Observation Huddles.
* Conduct concurrent reviews for all payers daily for the first three days of admission, then every 2-3 days, or more frequently if criteria are waning.
* Submit concurrent reviews to payers to ensure authorization of all days for per diem and percentage of charge reimbursement payers.
* If concurrent inpatient case does not meet medical necessity review criteria during the first level review, discuss with the attending MD to obtain additional clinical information and documentation to support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review.
* Forward cases that require secondary physician review to appropriate resource (e.g., Physician Advisor).
* Resolve any discrepancy at the time of review. If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership.
* Coordinate with the care team in changing patient status, as needed. Notify the care team when patient does not meet medical necessity per InterQual or MCG guidelines or 2 MN Rule and escalate appropriately.
* Document and proactively communicate relevant clinical information to payers for authorizations for treatments, procedures, and Length of Stay submit clinical information as required by payers.
* Ensure completion and delivery of required patient notices (by onsite team member). These include but are not limited to: HINNs, Condition Code 44, MOON, Connecticut notice of conversion, etc.
* Tracking and trending all appeals and communicating on a daily/regular basis with the Denials Management team.
* Assists with informing Managed Care contracting team with necessary contractual language to protect organization financial position specific to inpatient medical necessity requirements.
* Employs creative solutions with team members and leadership to prevent denials.
* Performs other duties as assigned.
Other Information:
Education Skills Experience
* Bachelor's Degree (BSN) is highly preferred.
* Minimum of Associate's Degree in Nursing required when accompanied by strong demonstrated competencies and significant experience.
* Minimum of 5 years experience in acute care Nursing
* Proficiency in Milliman and InterQual Guidelines required
* Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4 years experience required for Associate's Degreed individuals.
* PREFER: Master's Degree in related field
* Required: Current RN License in Connecticut and New York
* InterQual/MCG proficiency testing completed (preferred); required within 1 year of hire. As certification becomes available, requirement will be revisited.
* Knowledge of regulatory requirements for CMS
* Have the positive attitude and aptitude to adapt to the continuing change in payer behaviors
* Recognizes that education is the responsibility of the individual as well as the organization
* Seeks external knowledge on payers (such as free email services as Becker's)
* Must have analytical abilities to assist in obtaining solutions to problems
* Self-starter and highly motivated
* Must be able to work independently in a fast-paced environment, manage workload and prioritize work
* Must be able to manage multiple competing priorities and maintain calm professional demeanor during peak demand
* Must possess a high degree of prioritization skills
* Exceptional interpersonal skills to effectively communicate with the physicians, payers, and other members of the interdisciplinary care team
* Current working knowledge of utilization management, performance improvement and managed care reimbursement.
Working Conditions:
Manual: Some manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health
Org Unit: 2092
Department: Care Coordination
Exempt: Yes
Salary Range: $45.29 - $84.11 Hourly
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$30k-54k yearly est. 52d ago
RN - Cardiovascular Intensive Care Unit (CVICU)
Hartford Hospital 4.8
Hartford, CT jobs
Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler. Coast is featured on Blue Pipes' 2023 Best Travel Agencies and named a 2022 Top Rated Healthcare Staffing Firm & 2023 First Half Top Rated Healthcare Staffing Firm by Great Recruiters.
Please note that pay rate may differ for locally based candidates.
Please apply here or contact a recruiter directly to learn more about this position & the facility, and/or explore others that may be of interest to you.
We look forward to speaking with you!