Mount Sinai Medical Center
Join to apply for the
Utilization Review Registered Nurse
role at
Mount Sinai Medical Center
1 day ago Be among the first 25 applicants
As Mount Sinai grows, so does our legacy in high-quality health care.
Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.
Culture of Caring: The Sinai Way
Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.
Department
CC019054 Eldercare
Job Description Summary
Position Responsibilities
Participant Care Activities
Responsible to initiate and monitor service utilization including hospital, sub-acute, and post acute care utilized by participants.
Works with acute, sub-acute and post acute providers to ensure medical care provided is at the appropriate level for the current needs of the participant and proactively works with providers to make the changes needed to ensure the participants care needs are continually met.
Identifies reports and resolves actual or potential delays in service and assures appropriate use of resources
Development of plan of care for participants in collaboration with family, participant, caregiver, facilities and interdisciplinary team to facilitate a timely and safe discharge.
Attends medical rounds and/or care conferences in the hospital, nursing homes, or other in-patient care settings to evaluate the length of stay and utilization.
Works with case management or discharge planning facilities to assist in discharge planning or care transitions in a timely and safe manner
Makes routine visits to nursing home, assisted living facilities, hospitals, group homes and other home settings to assist in care coordination and ensure the participant is receiving the care designated in the plan of care
Assists participants, families and caregivers with End of Life Care needs
Complete the Department of Elder affairs 703B assessment as needed on participants
As needed conducts in person comprehensive initial and on going nursing assessments.
Counsels participants and families regarding health education, preventative health and chronic condition needs.
Provides on-call coverage on a rotating basis with other staff to troubleshoot, advise and coordinate participant care.
Covers for the Clinic Manager, Home Care Coordinator and/or Center Manager as needed.
Responds to diagnostic data and initiates appropriate action or intervention.
Planning
Re-evaluates plan of care as required by Eldercare standards and practices.
Establishes priorities for participant care based on participant needs as evidenced by completion of assigned duties.
Implementation
Uses nursing skills to determine participant clinical needs and assists the interdisciplinary team as needed.
Safely and correctly initiates and documents nursing interventions in emergency situations.
Perform in-house lab tests; obtain and process specimens for outside laboratories. Performs wound care and other nursing interventions as ordered by the physician or included in the plan of care.
Administers, observes, and documents intravenous therapy according to Eldercare policy.
Administers medications as required by physician orders.
Provides individualized instructions to participant/significant others regarding the plan of care.
Demonstrates safe and correct use of equipment.
Ensures that each participant's needs are met.
Take and record vital signs, recognize any variances, outliers or red flags, and take appropriate action.
Adheres to standard precautions including hand hygiene guidelines at all times.
Documents orders and other pertinent items as needed.
Reports all abnormal findings immediately to physician.
Performs and assists in procedures as needed.
Is able to administer oxygen therapy following physician's orders.
Evaluation
Documents/reports participant responses or outcomes resulting from: discharge planning or care transition activities, nursing interventions, treatments/procedures, interpersonal interactions, and participant/family education.
Evaluates and documents participant's progress towards established goals/objectives.
Updates/revises participant care problem list and individualized participant care standards based on participant/family responses, progress towards goals, and/or change in medical status.
Evaluates planning needs based on anticipated problems, internal or community resources, and support systems.
Professional and Staff Development
Completes 100% of the mandatory Eldercare and hospital specific in-services annually or as assigned, prior to the due date.
Establish, build and maintains community relationships to ensure continuity and continuation of care.
Collaborate with the Enrollment team for marketing, in-services and presentation needs.
Documents competency in clinical skills annually.
Attends staff meetings as required.
Uses established lines of communication for resolution of problems and interpersonal conflict.
Leadership
Ensures productivity daily and evaluates completion of duties assigned.
Fills in for Home Care Manager as needed, conducting home visits and initiating initial home assessments.
Fills in for Clinic Manager as needed, overseeing the clinic and its daily activities.
Fills in for the Center Manager as needed, overseeing the day center and its activities.
Participates in QI activities.
Qualifications
License/Registration/Certification
Current RN Licensure in State of Florida. BLS and CPR required.
Education
Graduated from accredited school of registered nursing.
Experience
One year clinical experience required. Experience in utilization review and/or case management in managed care, workers compensation or other health care setting is preferred. Geriatric physician office, or other case management experience is acceptable.
Benefits
Health benefits
Life insurance
Long-term disability coverage
Healthcare spending accounts
Retirement plan
Paid time off
Pet Insurance
Tuition reimbursement
Employee assistance program
Wellness program
On-site housing for select positions and more!
Core Responsibilities Accurately and completely reconcile medications across the continuum of care. Adheres to and complies with all regulatory standards globally to profession and specific to unit. All other tasks as related to the position's duties. Complies with current Hospital security and safety polices. Conduct a "time-out" immediately before starting the procedure as described in the Universal Protocol. Conduct a pre-operative verification process as described in the Universal Protocol. Ensures and understands the safety aspect of clinical alarms. Follows Patient Safety goals as established by the department; supports effective responses to adverse and sentinel events; provides an on-going proactive approach to reduce risk; integrates patient safety as a priority into new and existing processes. Follows the National Patient Safety goals as required: Improve accuracy of patient identification with at least two identifiers (excluding patient's room number). Improve the effectiveness of communication among caregivers. Improve the safety of using medications. Reduce the risk of health care-associated infections. Accurately and completely recon…
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Hospitals and Health Care
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Utilization Review Registered Nurse
role at
Mount Sinai Medical Center
1 day ago Be among the first 25 applicants
As Mount Sinai grows, so does our legacy in high-quality health care.
Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.
Culture of Caring: The Sinai Way
Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.
Department
CC019054 Eldercare
Job Description Summary
Position Responsibilities
Participant Care Activities
Responsible to initiate and monitor service utilization including hospital, sub-acute, and post acute care utilized by participants.
Works with acute, sub-acute and post acute providers to ensure medical care provided is at the appropriate level for the current needs of the participant and proactively works with providers to make the changes needed to ensure the participants care needs are continually met.
Identifies reports and resolves actual or potential delays in service and assures appropriate use of resources
Development of plan of care for participants in collaboration with family, participant, caregiver, facilities and interdisciplinary team to facilitate a timely and safe discharge.
Attends medical rounds and/or care conferences in the hospital, nursing homes, or other in-patient care settings to evaluate the length of stay and utilization.
Works with case management or discharge planning facilities to assist in discharge planning or care transitions in a timely and safe manner
Makes routine visits to nursing home, assisted living facilities, hospitals, group homes and other home settings to assist in care coordination and ensure the participant is receiving the care designated in the plan of care
Assists participants, families and caregivers with End of Life Care needs
Complete the Department of Elder affairs 703B assessment as needed on participants
As needed conducts in person comprehensive initial and on going nursing assessments.
Counsels participants and families regarding health education, preventative health and chronic condition needs.
Provides on-call coverage on a rotating basis with other staff to troubleshoot, advise and coordinate participant care.
Covers for the Clinic Manager, Home Care Coordinator and/or Center Manager as needed.
Responds to diagnostic data and initiates appropriate action or intervention.
Planning
Re-evaluates plan of care as required by Eldercare standards and practices.
Establishes priorities for participant care based on participant needs as evidenced by completion of assigned duties.
Implementation
Uses nursing skills to determine participant clinical needs and assists the interdisciplinary team as needed.
Safely and correctly initiates and documents nursing interventions in emergency situations.
Perform in-house lab tests; obtain and process specimens for outside laboratories. Performs wound care and other nursing interventions as ordered by the physician or included in the plan of care.
Administers, observes, and documents intravenous therapy according to Eldercare policy.
Administers medications as required by physician orders.
Provides individualized instructions to participant/significant others regarding the plan of care.
Demonstrates safe and correct use of equipment.
Ensures that each participant's needs are met.
Take and record vital signs, recognize any variances, outliers or red flags, and take appropriate action.
Adheres to standard precautions including hand hygiene guidelines at all times.
Documents orders and other pertinent items as needed.
Reports all abnormal findings immediately to physician.
Performs and assists in procedures as needed.
Is able to administer oxygen therapy following physician's orders.
Evaluation
Documents/reports participant responses or outcomes resulting from: discharge planning or care transition activities, nursing interventions, treatments/procedures, interpersonal interactions, and participant/family education.
Evaluates and documents participant's progress towards established goals/objectives.
Updates/revises participant care problem list and individualized participant care standards based on participant/family responses, progress towards goals, and/or change in medical status.
Evaluates planning needs based on anticipated problems, internal or community resources, and support systems.
Professional and Staff Development
Completes 100% of the mandatory Eldercare and hospital specific in-services annually or as assigned, prior to the due date.
Establish, build and maintains community relationships to ensure continuity and continuation of care.
Collaborate with the Enrollment team for marketing, in-services and presentation needs.
Documents competency in clinical skills annually.
Attends staff meetings as required.
Uses established lines of communication for resolution of problems and interpersonal conflict.
Leadership
Ensures productivity daily and evaluates completion of duties assigned.
Fills in for Home Care Manager as needed, conducting home visits and initiating initial home assessments.
Fills in for Clinic Manager as needed, overseeing the clinic and its daily activities.
Fills in for the Center Manager as needed, overseeing the day center and its activities.
Participates in QI activities.
Qualifications
License/Registration/Certification
Current RN Licensure in State of Florida. BLS and CPR required.
Education
Graduated from accredited school of registered nursing.
Experience
One year clinical experience required. Experience in utilization review and/or case management in managed care, workers compensation or other health care setting is preferred. Geriatric physician office, or other case management experience is acceptable.
Benefits
Health benefits
Life insurance
Long-term disability coverage
Healthcare spending accounts
Retirement plan
Paid time off
Pet Insurance
Tuition reimbursement
Employee assistance program
Wellness program
On-site housing for select positions and more!
Core Responsibilities Accurately and completely reconcile medications across the continuum of care. Adheres to and complies with all regulatory standards globally to profession and specific to unit. All other tasks as related to the position's duties. Complies with current Hospital security and safety polices. Conduct a "time-out" immediately before starting the procedure as described in the Universal Protocol. Conduct a pre-operative verification process as described in the Universal Protocol. Ensures and understands the safety aspect of clinical alarms. Follows Patient Safety goals as established by the department; supports effective responses to adverse and sentinel events; provides an on-going proactive approach to reduce risk; integrates patient safety as a priority into new and existing processes. Follows the National Patient Safety goals as required: Improve accuracy of patient identification with at least two identifiers (excluding patient's room number). Improve the effectiveness of communication among caregivers. Improve the safety of using medications. Reduce the risk of health care-associated infections. Accurately and completely recon…
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Hospitals and Health Care
Referrals increase your chances of interviewing at Mount Sinai Medical Center by 2x
Get notified about new Utilization Review Nurse jobs in
Miami Beach, FL .
#J-18808-Ljbffr