APRN - Utilization Management​/Physician Advisor Services

Join the team that is revolutionizing health care – Bay Care 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.

• 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/Inter Qual placement status criteria.

• 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

• Required – APRN (Advanced Practice Registered Nurse)
• Preferred– Board certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP)

• Required – Bachelor’s Nursing
• Preferred – Master’s Nursing

• Required – 3 years healthcare

Bay Care Health System

St. Joseph's Hospital

Full Time, Exempt:
Yes

8:00am - 4:00pm

None

Always