DaVita Utilization Management Nurse in St. Petersburg, Florida
OVERVIEW OF POSITION:
The Affiliate Utilization Management Nurse will focus mostly on hospital/SNF inpatient review and discharge planning. Telephone review with physicians, facilities, and insurance companies will be supplemented with medical record reviews.
Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer.
Represents the Company in a professional manner, following all Company policies and procedures.
Uses, protects, and discloses DaVita Medical Group patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Conducts concurrent reviews and coordinates discharge planning activities with the Primary Care Physician office.
Identifies candidates for the Company’s Disease Management and Complex Care Management Programs.
Communicates findings to the Affiliate leadership team.
Participates in special projects as assigned.
Performs additional duties as assigned.
Ability to travel may be required.
Current Florida RN license.
- Highly skilled LPN may be considered.
- Prior UM experience necessary. Hospital experience helpful
KNOWLEDGE, SKILLS, ABILITIES:
Ability to apply utilization management criteria, and conduct telephone inpatient review of hospital/SNF patients.
Must be able to review medical records at times.
Ability to coordinate discharge plans.
Excellent clinical knowledge required.
Ability to be nimble and learn to think out of the box important.
Ability to be professional in all dealings within and outside the company.
Excellent verbal and written communication skills.
Ability to read, write, speak, and understand the English language fluently.
DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Colorado, Florida, Nevada, New Mexico, Pennsylvania and Washington. A leading independent medical group in America, DaVita Medical Group has over two decades of experience providing coordinated, outcomes-based medical care in a cost-effective manner. As of June 30, 2017, DaVita Medical Group’s teammates, employed clinicians and affiliated clinicians provided care for approximately 1.7 million patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.