We're seeking a Clinical Utilization Review Nurse Preceptor (Registered Nurse / RN). This individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor:
- Will be regarded as a clinical expert, leader, and role model within the Utilization Review Department as it relates to the understanding and application of the Utilization Review process in its entirety.
- Will have expert clinical skills as well as an in depth understanding of the revenue cycle as a whole.
- Will demonstrate foresight regarding the impact of both the clinical and administrative roles within the utilization review process based on critical thinking, intuition, and experience.
- Facilitates efforts to support compliance and adherence to standard work, policies and procedures, clinical criteria guidelines, status designation, notification and authorization, compliance and regulatory standards, and case management systems.
- Understands the key performance metric indicators for the department and supports the team in reaching them. remains up to date with industry standards, regulatory and compliance standards/updates, and keeps informed of best practices within the industry in an effort to incorporate innovative solutions into the Utilization Review Department.
- Will be responsible for new hire onboarding, training, and competency completion.
- Will be responsible for ongoing departmental education to ensure utilization review is a high performing department. This will consist of regular audits of each staff member which will assist with identification in knowledge gaps and/or education needs.
- Will be responsible for developing and executing individualized training plans as needed based on audits.
- Will assist with the development of both clinical and administrative skills by ensuring the staff have opportunities to acquire necessary knowledge, skills, and attitudes to fulfill the expectations of their roles.
- Will role model and encourage these skill sets. T
- Will coordinate with Case Management leaders to ensure policies, procedures, and standard work are consistently updated and maintained and employees are trained appropriately and timely in order to ensure consistent expectations and maintain quality throughout the department.
- Is required to ensure all training materials are kept organized, updated, and readily available for reference at any time.
- Must ensure yearly and new competencies/validations are completed and filed for employees for all new hires as well as for new initiatives, projects, and/or processes.
- Will play a vital role in partnering with Physician Advisors to ensure the Physician role as well as the UR RNs roles are continually optimized.
- Functions as part of the departments leadership team and provides direct coverage/support to leaders as necessary.
- Must meet expectations on yearly evaluation and may not have any active performance management or disciplinary action.
- Successful completion of yearly competencies.
MINIMUM QUALIFICATIONS:
- Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board.
- Bachelors degree in nursing required.
- Masters degree in Nursing, Education, or related field preferred.
- 3-5 years recent healthcare experience.
- 3-5 years experience in UR.
- Minimum 1 year as UR RN II or equivalent experience.
- Case Management certification preferred.
JOIN OUR TEAM TODAY! Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.