Utilization Review Nurse - Palliative

About This Role

This role as a Palliative Utilization Review Nurse involves evaluating and re-evaluating patient and family needs and conditions to support appropriate care decisions. The nurse acts as a liaison between primary care and palliative care providers, ensuring continuous communication regarding treatment changes and all aspects of patient care. The position is well-suited for a Registered Nurse with experience in direct patient care for life-limiting illnesses.

Responsibilities

• Evaluate and re-evaluate patient and family needs, symptoms, and condition to report accurately to Palliative Care providers for appropriate care decisions
• Serve as the liaison for primary care physicians and palliative care providers regarding physicians’ orders for the care plan
• Communicate continuously with physicians and other health care personnel concerning changes in medical treatment and all other aspects of patient care
• Provide education and counsel to the patient and family regarding palliative care and their plan of care
• Coordinate community resources for patients’ needs as assessed by the palliative care team in conjunction with the social worker
• Apply principles of infection control and follow guidelines for universal precautions in accordance with accepted professional practices
• Attend, participate, and may facilitate interdisciplinary group conferences (IDG) and special care conferences
• Assume responsibility for establishing and maintaining effective working relationships with team members
• Identify specific patient and caregiver needs and make referrals to appropriate team members
• Assist the administrative assistant with managing the referral process, provider assignments, and provider information
• Ensure accurate, complete, succinct, and timely clinical documentation in accordance with VIA Health Partners guidelines and licensure and certification standards
• Review and update pain contracts for each palliative care provider on a weekly basis
• Demonstrate competency in knowledge and skills
• Ensure that VIA Health Partners' professional reputation is maintained and projected
• Assume responsibility for professional development and staying abreast of current trends in the healthcare field, incorporating new information and methods into practice
• Maintain current professional licensure, CPR certification, and CEU requirements
• Maintain productive and professional relations with external agencies and healthcare providers
• Exhibit time management skills, able to plan workday while remaining able to respond appropriately to crisis
• Perform other duties as required

Requirements

• Diploma or associate degree in nursing is required; bachelor’s degree preferred