Virginia Mason Memorial Registered Nurse (RN) - Utilization Management in Yakima, Washington
All staff members at Yakima Valley Memorial must be in compliance with our Vaccination Policy, which includes the COVID-19 (SARS-CoV-2) vaccine, by their first day of employment.
In accordance with the objective and goals of the Utilization Management Plan, the Utilization Management (UM) RN coordinates and monitors the daily activities of the Utilization Management department, ensuring the appropriate allocation of hospital resources while maintaining quality of patient care. This RN also ensures regulatory compliance and coordination of clinical review requests from external entities. The UM RN serves as a functional expert and liaison to the Care Coordination staff and other departments within the Yakima Valley Memorial (YVM) system. The UM RN assists the Director to develop consistent processes to enhance the workflow for overseeing the concurrent review process with third party payers. The UM RN oversees and facilitates medical necessity appeals that result from concurrent denials. The UM RN functions as the LiVanta Liaison facilitating the review process for Hospital Issued Notices of Non-Coverage (HINN’s) and discharge reviews as they relate to Care Coordinator activities. The UM RN follows up with the Care Coordination department in issuance of Condition Code 44s, ensuring appropriate documentation and notification of patients and related hospital departments.
QUALIFICATIONS AND REQUIREMENTS Education: Associate’s degree in nursing required; BSN preferred. Experience: Five years recent acute care experience required. Minimum of two years of utilization review/case management experience in an acute care setting preferred. Licenses/Certificates/Registration: Washington State (DOH) Registered Nurse licensure required. American Heart Association BLS required until certified in ACLS. ACLS required within one year of hire (if applicable).
Yakima Valley Memorial (YVM) is primarily a 256-bed acute-care, not-for-profit community hospital that has served Central Washington's Yakima Valley for 70 years. YVM extends beyond the existence of a community hospital, including a multispecialty team of more than 200 physicians and 20+ primary care and specialty care locations. Specialty care services include cardiac care, a continuum of cancer care, hospice care, and advanced services for children with special health care needs.
As the region’s leading health care provider and Yakima’s largest employer, we believe that by improving health, we can transform Yakima! Our vision at YVM is creating healthy communities one person at a time. With such an important vision, our diverse workforce bands together to demonstrate our values of Respect, Accountability, Teamwork, Stewardship, and Innovation for everyone who walks through our doors, patients and coworkers alike.
We believe that the way we treat our patients, and our fellow employees is a vital part of the job we do every day. Together, we can create loyal, enduring partnerships with our patients, our community, and one another; while staying focused on improving the quality of life for our patients and the overall quality of the organization. At Yakima Valley Memorial, we listen to staff ideas and empower them to innovate and create changes.
At YVM, we are committed to establishing a diverse and encouraging workplace that supports all employees, appreciating their unique backgrounds and experiences. We believe our culture enables us to meet our mission and values while serving patients, current employees, and any prospective employees in the Yakima Valley. We hope you join us in our passion for delivering remarkable patient care and on what’s most important to us – making you better so our patients get better.
WHAT WE OFFER:
At YVM, we know the best care is provided by employees who are well-supported. We recognize that our staff is our most valuable resource! We are proud to offer all employees an excellent Total Rewards Package that is well-rounded in the elements that matter to you and your family. Our goal is to attract, retain, and motivate high-quality staff members to continue contributing to patient care locally in the Yakima Valley. These offerings include:
We offer comprehensive medical, dental and vision plans to meet the needs of you and your family. Benefits include:
Offerings of two (2) medical plans covering a range of providers and services within the Yakima Valley and beyond
Saving and spending accounts to set money aside tax-free for health care and dependent care expenses, including a Health Savings Plan (HSA) that ranks above all Health Care 500+ and Fortune Best Benchmarks with a generous employer contribution
Access to virtual care
Variety of wellbeing programs, resources and initiatives
Retirement Plans: We offer pre-tax and Roth voluntary 401k programs for employees to contribute into. In addition to your contributions, after one year of employment we offer a generous double match which consists of the following:
We will match on your 401k deferrals, assuming a minimum contribution.
We will contribute a flat percentage of your eligible income into your 401k account. All contributions are 100% employee vested immediately.
A competitive compensation program: A market-driven compensation program that rewards employees for their experience -- with potential opportunities for degree and certification pay, recognizing employees for their skills and initiative to grow. Opportunities are offered for performance-based bonuses to reward the dedication and innovation of our staff and leaders.
Additional perks that inspire our employees to thrive, grow, and be well, including:
A generous Employee Assistance Program
On-Site Employee Health Clinic
Fitness and wellness Partnerships
A Tuition reimbursement program
At YVM, we:
Improve the patient experience of care, the health of our community, and the work life of our team members, all while reducing the cost of health care
Provide culturally compassionate healthcare to all patients
Drive toward better healthcare outcomes and experiences
Aim to be proactive and agile as the healthcare industry changes
Our core purpose is to inspire people to thrive! Please join us as we create a healthy Yakima, one person at a time.
“Yakima Valley Memorial provides reasonable accommodations to assist qualified individuals in order to perform the essential duties/requirements their job requires. The description is intended to provide only basic guidelines for meeting job requirements and serves as merely a summary rather than a complete listing of duties. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. This job description does not constitute a contract as employment is at will.”