Shire Jobs

RN -Special Services Nurse

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[QUALITY/UTILIZATION REVIEW [FT,Day Shift [Req #2539 *Title: Special Services Case Nurse *REPORTING RELATIONSHIPS: CQO *GENERAL SUMMARY OF RESPONSIBILITIES: Provides staffing in the areas of utilization management, social services, discharge planning, infection control surveillance and reporting, and provides assistance to Occupational Health and Infection Preventionist . This position requires rotating call and some weekend and holiday work. *Essential Job Functions: 1. Performs clinical review of inpatient or outpatient service request using clinical judgment, nationally accepted clinical guidelines, knowledge of departmental procedures and policies within timeliness guidelines for pre-service, urgent or concurrent review. 2. Utilization review of all hospitalized patients and ongoing case review as required by third party insurance companies 2. Issues notices of non-coverage under the direction of theSpecial Services Manager or CQO 3. Screen patients for discharge planning needs and assists patients with arrangements 4. Participates in infection control surveillance 5. Prepares a variety of reports requestedby Special Services Manager, Quality Management Specialist, Infection Preventionist and CQO 6. Assists with employee immunizations and safety education. Participates in infection surveillance and patient and staff education related to isolation precautions. 7. Provides Social Service staffing and is on-call for Social Services and Utilization Management.Assists patients with the formulation of advance directives. 8. Actively participates in Quality Management and Hospital Safety Programs. **Other Job Functions: 1. Works with CQO on special projects with other team members 2. Completes client assessment forms as required bylicensing and regulating bodies 3. Participates in planning and presenting employee education programs 4. Serves on assigned committees 5. Performs other related duties as assigned or requested. 6. Provide patient care within the scope of a license/ certificate 7. Take Rotating Call

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