Infection Prevention & Case Management​/UR Nurse

Brief Description

The Infection Prevention & Case Management/Utilization Review Nurse is responsible for planning, implementing, monitoring, and evaluating the health system's infection prevention and control program while simultaneously coordinating utilization review and case management activities to ensure regulatory compliance, patient safety, quality outcomes, appropriate resource utilization, and reimbursement integrity.

This position serves as the designated Infection Preventionist in accordance with CMS Conditions of Participation and supports organizational compliance with CDC, NHSN, APIC, CMS, state health department, and accreditation requirements. The role also conducts admission reviews, concurrent reviews, observation reviews, swing bed skilled nursing reviews, and utilization management functions to ensure patients receive the appropriate level of care consistent with medical necessity criteria.

• Serves as the designated Infection Preventionist for the health system.
• Develops, implements, maintains, and evaluates a comprehensive infection prevention and control program.
• Ensures compliance with CMS Conditions of Participation, CDC guidelines, APIC standards, OSHA regulations, and state reporting requirements.
• Conducts annual infection risk assessments and develops organization-wide infection prevention goals and action plans.
• Participates in Quality Assessment and Performance Improvement (QAPI) activities related to infection prevention and patient safety.
• Collaborates with medical staff, nursing leadership, pharmacy, environmental services, laboratory, employee health, and administration regarding infection prevention initiatives.

Provides support for antibiotic stewardship activities and monitoring.

• Conducts ongoing surveillance for healthcare-associated infections (HAIs).
• Identifies trends, outbreaks, clusters, and opportunities for performance improvement.
• Monitors infection indicators including, but not limited to:
• CLABSI
• CAUTI
• SSI
• MRSA
• C. difficile
• Multidrug-resistant organisms
• Respiratory and communicable diseases
• Coordinates outbreak investigations and implements mitigation strategies.
• Serves as liaison to local and state public health departments.
• Ensures implementation of transmission-based precautions and isolation practices.
• Monitors hand hygiene compliance and infection prevention best practices.

• Maintains facility enrollment and participation in CDC's National Healthcare Safety Network (NHSN).
• Collects, validates, analyzes, and submits required NHSN data.
• Ensures accuracy and completeness of reportable HAI events using NHSN definitions and criteria.
• Oversees reporting requirements related to:
• HAI surveillance modules
• Antimicrobial Use and Resistance (AUR) reporting
• Healthcare personnel vaccination reporting
• CMS quality program reporting requirements
• Other NHSN reporting modules as applicable.
• Produces monthly, quarterly, and annual infection surveillance reports.
• Benchmarks organizational performance against national NHSN data.
• Presents findings to leadership, Quality Committee, Medical Staff, Infection Prevention Committee, and Board as required.

• Develops and delivers infection prevention education programs for employees, providers, volunteers, students, and contracted personnel.
• Provides orientation education regarding infection prevention practices.
• Assesses staff competency related to:
• Hand hygiene
• PPE use
• Isolation precautions
• Sterile technique
• High-level disinfection
• Device-associated infection prevention
• Safe injection practices
• Conducts audits and competency validation activities.
• Provides patient…