RN Utilization Review Full-time
Health & Hospital Corporation

QUALITY REVIEW BEHAVIORAL NURSE SPECIALIST

apartment Health & Hospital Corporation location_onIndianapolis, IN 46205, US
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Health and Hospital Corporation is an organization that celebrates diversity, and seeks to employ a diverse workforce. We actively encourage all individuals to apply for employment and to seek advancement opportunities. Health and Hospital Corporation also provides reasonable accommodations to qualified individuals with disabilities as required by law. For additional questions please contact us at: hrmail@hhcorp.org.

Job Role Summary

Assists the Long Term Care department in the review and analysis of care and services provided by HHC owned nursing homes and licensed residential facilities. Performs on site, overnight as needed, and office review of various clinical resident care services and management operations at HHC affiliated long term care facilities and participates in the preparation of related reports for the long term care department, individual facilities and the contract management company. Assists in the analysis of various aspects of nursing home operations using professional standards of practice and industry benchmarks. This position is responsible for promoting health and wellbeing of long term care residents of Health & Hospital Corporation Marion County nursing facilities by promoting preventive, therapeutic, and supportive care based on standards of practice and in compliance with all applicable regulatory requirements with an emphasis on resident behavior health needs including dementia, addiction and current DSM manual (DSM-5-TR).

Essential Duties

Responsibility 1: 70%

• Performs quality review oversight, including overnight as directed, visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as the sole representative from the HHC Long Term Care Department. Maintains a professional and supportive role when interacting with the nursing home and licensed residential facility staff providing helpful observations and suggestions.

• Performs various auditing/review activities during the site visits including but not limited to:  meal service observations, resident care observations, resident  and family interviews, staff interviews, clinical record reviews and review of facility management records. At times may assist the other members of the quality review team to complete their assigned tasks.

• Performs various auditing/review activities during the site visits including but not limited to:  observations of resident behavioral interaction/intervention, medication administration, wound care, personal care services, meal service, clinical record reviews and review of nursing management records.

• Participates in the exit conferences held with facility management and the quality reviewers and provides summary information regarding significant observations during the facility visit including specific resident and employee identification when possible.

• Prepares a written site visit report following each facility visit in cooperation with other quality review team members who participated in the facility visit. Reviews report for accuracy, and clarity. Distributes reports in a confidential manner to all parties and maintains HHC records.

• Assures the retention and confidentiality of all data materials from facility visits and forwards to the department Executive Assistant for proper storage/retention.

 

Responsibility 2: 30%

• Participates in the compilation and completion of quarterly and other reports prepared for the HHC Board of Trustees’.

• Accepts phone calls from residents, family members and interested parties in the absence of other Long Term Care Department staff or as assigned. Receives concerns or information in a manner that reflects good customer service practices and prepares detailed written information for the Vice President’s review and processing.

• Attends community and professional association functions and meetings representing HHC Long Term Care division, as requested.

• Follows departmental travel policy for travel arrangements/reservations for out of town facility site visits.

 

Qualifications

• Registered nurse with four or more years experience including two or more years of behavioral health background. 

Licenses/Certifications Required

  • Registered Nurse (RN)

Knowledge, Skills & Abilities

• Good judgment and discretion in communication (written, verbal and non-verbal).Must be able to prioritize work, meet deadlines, and work well under pressure.

• Flexibility to adjust to changing program/department needs and activities.

• Excellent verbal and written skills.

• Must be proficient with Microsoft Office, Word, Internet Explorer, and all usual and customary office equipment.

• Must possess the ability to work independently, and as part of a team.

Working Environment

  • Unconfined sitting 75%
  • Confined sitting 15%
  • Standing or walking 10% (50% - on site visit days)
  • Steady use of hands or fingers – Typing and filing 85%
  • Lift, carry, etc. with arms and legs – 15%
  • Ability to perform driving functions in normal course of workday with confined sitting for several hours at times

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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