RN Jobs in West Haverstraw, NY

Utilization Management Registered Nurse

The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services in accordance with established criteria, regulatory requirements, and organizational role. The UM RN ensures optimal patient care delivery while supporting compliance, quality outcomes, and effective resource utilization. The role is responsible for the assessment of medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate but ensures that an authorization is obtained from the payer, if required, and that the documentation supports the care delivered in such a way that minimizes risks of denials.

RN

Per Diem

5 days ago

REGISTERED NURSE PER DIEM (JR229084)

Montefiore The Bronx, NY

Introduction To heal, to teach, to discover and to advance the health of the communities we serve. To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here . Overview For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors. The RN participates in performance improvement/research activities; maintains professional practice standards and clinical expertise; and demonstrates leadership skills. The RN demonstrates core and unit specific competencies based on the patient population served. Responsibilities Demonstrates leadership skills in the coordination and delivery of patient care. Coordinates an interdisciplinary plan of care. Assures 100% assigned patients have a documented plan of care. Ensures completion of patient care assignment 100% of time. Interdisciplinary plan of care is congruent with accepted LOS parameters for all assigned patients. Delegates aspects of care of the patient to team members consistent with capabilities and responsibilities of caregiver. Ensures that delegated aspects of care are completed in accordance with established standards of practice. Negotiates with team member if unable to fulfill role responsibilities; escalates as per MMC policy and procedure. Establishes a therapeutic relationship with patient/family. Assumes charge nurse assignment. Participates in the orienting and development of associates by mentorship and assigned preceptorship. Patient/family wishes related to care decisions are assessed and documented. Systematically assesses the health care of patients/families and responses to care rendered. Completes 100% of admission assessment within 8 hours. Completes documentation reflecting interdisciplinary team approach as per policy. Documentation reflects systematic and continuous collection of data. Documents teaching/learning needs of patients and families prior to discharge. Assesses, evaluates and documents patient's response to nursing and interdisciplinary team interventions, including patient/family teaching. Initiates a teaching and discharge plan for 100% of assigned patients within 24 hours of admission. Modifies plan of care through prioritization of patient/family needs and interdisciplinary orders. Demonstrates critical thinking skills to problem solve and initiate clinical decision making. Takes action to optimize achievement of patient outcomes. Participates in identification, Investigation and resolution of actual and/or potential risk management/quality care/ethical issues. Incorporates effective problem solving/conflict resolution/consensus building into daily practice. Evaluates patient progress toward health goals and modifies critical path or plan of care accordingly. Identifies variances to plan of care. Initiates appropriate interventions to amend identified variances from plan of care. Documents patient and family response to interventions and modifies plan of care as needed. Reviews plan of care daily and/or updates it to reflect current status of patient. Consistently participates and communicates in daily IDT rounds to provide concise direction to all caregivers. Develops, coordinates and provides direct care for specific patient assignment. Provides patient-focused care. Incorporates standards of practice, critical pathways, age-specific guidelines and patient care guidelines into plan of care. Assess potential and actual changes in level of care required. Develops plan of care within 24 hours of admission to the extent possible. Includes patient/family in care planning. Provides a safe environment for patients/families. Orients patient/family to environment assuring comprehension of information presented. Administers medication according to the medication administration policy. Responds appropriately to urgent/emergent situations. Utilizes and documents use of restraints according to hospital patient care guidelines. Uses equipment in accordance with MMC policies and procedures. Provides comprehensive direct patient care to assigned patients. Utilizes knowledge of nursing, research and evidence based practice in the application of care and clinical judgment. Administers care consistent with standards of care for MM. Nursing interventions demonstrate consideration of patient's bio psychosocial and spiritual needs. Communicates effectively with patient/family and members of the health care team. Defends and preserves the rights of patients relative to all aspects of care, information, knowledge and privacy. Demonstrates respect of cultures and respect for cultural diversity with co-workers and other health care team members, patients, families and co-workers. Incorporates the principles of patient focused care in daily practice. Recognizes the family as defined by the patient. Communicates interdisciplinary plan of care to 100% of assigned patients and families within 24 hours of admission and daily. Identifies patient satisfaction/dissatisfaction with plan of care. If patient expresses dissatisfaction, implements conflict resolution skills, and escalates issues with plan of care. Assesses and documents patient advanced care directives for 100% of assigned patients. Establishes collaborative and collegial relationships with health care team members. Documents legibly. Requirements Demonstrates responsibility for maintaining competencies and participates in activities contributing to the growth and development of self, colleagues and the nursing profession. Provides two examples of ongoing professional development. Contributes to growth and development of staff and students through participation in peer review, mentor relationships, formal and informal education. Recognizes that professional responsibility extends beyond one's own patient population; assists and supports team members. Attends at least one hospital committee meeting or in-service annually and shares information with coworkers. Demonstrates active participation in unit-based performance improvement initiatives. Is responsible and accountable for own practice. Ensure compliance with written policies, procedures and standards of practice/care as defined in the R.N. position summary. Critical thinking/problem solving skills are incorporated into nursing practice. Contributes to problem identification and problem solving in the work environment, participating on task forces and groups as necessary. Supports the mission, vision, values and balanced scorecard performance measures for Montefiore Medical Center and standards of nursing practice. Attends an educational program at least annually and provides feedback to co-workers about educational content. Attends unit-based in-services as scheduled. Conforms with MMC dress code. Conforms with MMC attendance and punctuality policy. Maintains licensure and current registration. Maintains mandatory certification, and competency including but not limited to annual review, BLS, etc. Integrates the standards of excellence into daily clinical practice. Respect: Honors and values each person. Effective Communication: Effectively listens, conveys, and receives ideas, information, and direction. Sensitivity: Demonstrates willingness and ability to listen and understand others' feelings, needs and circumstances. Professionalism: Demonstrates confidence, competence and pride in work and appearance. Exceeding Expectations: Assists others without being asked. Courtesy: Treats everyone with kindness and care. Qualifications BSN in Nursing Preferred. NYS License for Registered Professional Nurse and current registration or valid permit to practice in NYS as an RN Required. NYS Mandated Infection Control and Child Abuse Reporter Training Required. Basic Life Support (BLS) Training Required. OHS Annual Assessment Required. OHS Fit Test Required. Certification in specialty Upon Hire Required. Pediatric Advanced Life Support (PALS) Training Upon Hire. At least 1 year Hospital or Clinic setting experience Preferred. Ability to use basic data entry and retrieval systems. Effective English communication skills, both written and oral.