Hope House is looking for professionally minded individuals that will uphold our corporate values including unconditional kindness and professionalism. We have been in business for over thirty years, experiencing continual growth and name recognition in the field of drug and addiction rehabilitation.
Utilization Review Nurse
The Utilization Review Nurse is responsible for completing clinical reviews for medical necessity, quality and related reviews; consistently applies medical health benefit policy and medical management guidelines to determine whether services are authorized, including whether services are appropriate and justified; reviews performed by the individual in this position may be pre-service, concurrent or retrospective in nature and will fluctuate based on the needs of the organization and the priorities set by management.
KNOWLEDGE, SKILLS AND ABILITIES
Comprehends complex clinical data.
Computer and management reporting and analysis skills.
Organizes, prioritizes, and manages time effectively.
Ability to learn quickly and be flexible.
Requires effective interpersonal and communication skills, both written and verbal, and the discretion to manage confidential patient information from medical records and other internal and external sources.
Possesses the ability to make decisions of a highly complex nature with minimal direct supervision.
Maintains strict confidentiality of all data and information.
Exercises discretion in all interactions and maintains a reputation of trustworthiness among peers and medical staff.
Substance Abuse Nursing: 1 year (Preferred)
Registered Nurse (RN) (Preferred)
Hope House Treatment Center is seeking a Charge Nurse to join its multidisciplinary treatment team, to assist with carrying out physical and mental health services protocols for patients. The charge nurse is responsible for overseeing the day-to-day operations of the nursing staff while on duty and working closely with the Director of Nursing to insure that all policies and procedures are followed, making recommendations for changes and improvements, and acting in the capacity as the Director of Nursing in their absence. The charge nurse carries additional responsibilities over and above the staff nurse, as outlined in the position description. The charge nurse must apply nursing principles and processes within a biopsychosocial conceptual framework for identification, assessment, and treatment of addicted persons at all levels of care, including Detoxification, Intermediate, and Extended care. The Charge Nurse must hold an active RN license issued by DHMH Maryland Board of Nursing.
Responsibilities include (but are not limited to):
Maintains nursing schedule on a weekly basis to insure adequate nursing coverage on all shifts and covers empty shifts when necessary.
Oversees daytime nursing staff activities to insure compliance with all policies and procedures. Identifies problem areas, makes suggestions for improvement, and works closely with the Director of Nursing to insure ongoing quality treatment in all nursing functions.
Attends the Morning Team Meeting, representing the Nursing Department for all Treatment Team reviews. Checks previous day’s admission electronic records for completion of all appropriate forms, and reviews Nursing Treatment Plans initiated for thoroughness and relevance. Reports any significant outcomes regarding treatment team decisions/issues to the Director of Nursing.
Participates with the Director of Nursing, Director of Treatment, and Medical Director in program design and implementation of changes as appropriate to the population served.
Provides on-site training in Hope House policy and procedure to new nurses while orienting. Completes orientation sheets for all new nurses and is responsible for annual evaluations as assigned by DoN.
Implements safe, effective, efficient nursing care. Care may be delegated to other members of the treatment team and must be consistent with the nursing scope of practice. Interventions include but may not be limited to:
Health education via weekly didactics;
Assists patients to break through unhealthy defenses by accurately reflecting behaviors and consequences of substance abuse and addiction;
Assists primary counselors with referrals for care
Respects patient rights
Communicates in a timely manner and effectively through:
Written documentation in clinical record
Oral communication with treatment members
Communicates changes in health status to the physician and/or NP as appropriate
Maintains client confidentiality
Coordinates care for methadone clients who have their doses transferred to/from outside clinics while in treatment
Serves as primary utilization review nurse to include the following activities:
Obtains insurance and third party payer authorizations for all patients/clients
Maintains all patient records regarding third party payer reviews, re-certifications, and special authorizations
Effectively uses Emergency/Crisis response procedures.
Demonstrates cultural competency when interacting with clients and co-workers
Able to design and implement forms in the Credible electronic record
Assists DoN with CARF preparation activities including policy development and review
Promotes a positive image of the organization through his/her dress, demeanor, and interaction with clients, co-workers, and the general public
Accepts and carries out other duties as assigned
A nursing degree from an accredited school.
Registration as active RN license issued by DHMH Maryland Board of Nursing.
Preferred prior experience in nursing in supervisory capacity.
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand and walk.
Addictions Nursing: 1 year (Preferred)
Supervisory: 2 years (Preferred)
Behavioral Health: 1 year (Preferred)
Registered Nurse (RN) (Required)