APRN - Utilization Management/Physician Advisor Services

Join the team that is revolutionizing health care – BayCare Health System

Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility, and clinical excellence.

Our team members focus on tomorrow by achieving personal and professional success today. That's why you'll thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve.

Title: Advanced Practice RN –UM/PAS

Responsibilities:

• Serving the health system through assisting Physician Advisors on a hospital and system level with clinical reviews and data analysis in collaboration with the Care Management, Utilization Review/Denials, Clinical Documentation Integrity, Coding, and Managed Care departments.
• Assists Physician Advisors to develop and implement methods to optimize use of hospital services for all patients while also ensuring the quality of care provided by efficient management of resources, ensuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance and monitoring the appropriate use of diagnostic and therapeutic modalities.
• Primary focus will be on assisting with denials prevention and management.
• The APRN - UM/PAS will also assist with the administration and functioning of the Physician Advisor program.
• Required qualifications includes Advanced Practice Registered Nurse obtaining graduate education at the masters, post-master’s or doctoral level and obtain national board certification.
• Preferred qualifications include Non-Physician Member of the American College of Physician Advisors (ACPA); Familiarity with MCG/InterQual placement status criteria.

BayCare offers a competitive total reward package including:

• Benefits (Medical, Dental, Vision)
• Paid Time Off
• Tuition Assistance
• 401K Match and additional yearly contribution
• Annual performance appraisals and team award bonus
• Family resources and wellness opportunities
• Community perks and discounts 

License:

• Required – APRN (Advanced Practice Registered Nurse)

Education:

• Required – Master’s Nursing

Experience:

• Required – 3 years healthcare in an acute care facility at an APRN level

Facility: BayCare Health System, Physician Advisor Services-HSS

Location: St Josephs Main and Childrens

Status: PRN, Exempt: No

Shift Hours: Flexible hours, 10-15 hours per pay period

Weekend Work: Occasional

On Call: No

How often will this team member be working remotely? Always

Equal Opportunity Employer Veterans/Disabled