Utilization Review UR

The RN, is responsible for accurate completion of screenings as reflected in the workflow by addressing barriers with focus on care gaps and patient goals. Schedules appointments within the appropriate discipline based on proactive care needs.

Provides education based on national guidelines specific to the screening test results.

Provides education on reducing risk factors, healthy lifestyle choices, and refers to appropriate resources.

Sets-up, performs, and/or assists with procedures as appropriate. within scope of practice and skill (i.e. Administers vaccines/ immunizations, performs manual blood pressure, weight / height, BMI, etc.). 

Monitors patients response during and post procedure.

Assesses and triages patients presenting to the health care setting, including unscheduled patients, emergencies and others using critical thinking

Reviews client consent and other forms for completeness and legibility before offering services.

Accurately documents patient assessment, data, actions, interventions, and patient response according to established guidelines and policies.

Assist with event setting / closing; ensures all equipment and forms are stored and tracked appropriately.

Ensures a clean and functional work environment.

Uses critical thinking and clinical assessment skills to handle emergency situations; i.e. reaction to vaccine/ immunization.

Responds effectively to member / patient concerns, serves as an advocate for the patient.

Demonstrates customer service skills to include; diplomacy, patience, problem solving with a range of clientele.

Adjusts to fluctuating work flows and changing assignments; is expected to demonstrate quality and effectiveness in work habits and clinical practice; and treats co-workers, patients, families, and all members of the health care team with dignity and respect.

Acts as a resource to the team, resolves problems with dignity and respect. 

Brings unresolved issues to the managers attention if unresolved by the team.

Able to provide clinical services in a variety of settings (i.e. clinic, employer group sites, mobile health vehicle, etc.).

Conducts outgoing telephone calls to patients requiring preventative outreach.

Provides follow-up care to patients by providing outgoing telephone calls, follow-up interaction, coordinating referrals, scheduling follow-up appointments, call in/fax in prescriptions, obtain and integrate lab, x-ray and other results, and manage physician orders for lab/x-ray per guidelines.

Completes other department-specific procedures and nursing care within scope of practice and skill.

Assists with event logistics and coordination such as but not limited to inventory, supplies availability, event tracking and reporting.

Participates in the development and maintenance of data collections and report requirements. Provides recommendations and implements process improvements.

Attends and participates in departmental meetings as required and/or requested.

Completes required staff development and other trainings as requested.

participates in employee job safety analysis to eliminate hazards and prevent accidents, cooperates to investigate employee and volunteer injuries, promotes and support safety awareness and implement safety operations, encourages staff to make suggestions on safety practices.

Leads or participates in quality improvement activities and/or initiatives.

Serves as a role model for quality and service and as a resource, coach and mentor for other members of the Health Care Team.

Performs other duties as assigned