Apply today to join our team!
Be part of something bigger
At MCH, you'll collaborate with a diverse and knowledgeable team, contributing to the high-quality care we provide to our community. We value your passion for patient care and teamwork.
The UR/CM RN will collaborate with payer care managers to review clinical criteria and address potential care denials proactively, minimizing the risk of retrospective denials. This role is central to coordinating discharge plans tailored to each patient’s needs, working with the healthcare team to streamline care and ensure a smooth transition post-hospitalization. The UR/CM will also support and educate hospital staff to deliver high-quality, cost-effective medical care. If you are an experienced RN with a focus on patient-centered care and resource management, consider joining our dedicated team, where every employee plays a vital role in providing quality healthcare to our community.
Responsibilities:
- Serves as a comprehensive care coordinator for patients, ensuring appropriate care, treatment, and continuing care using a multidisciplinary, team-based approach.
- Collaborates with physicians and allied health staff to develop individualized care plans and goals, suggesting revisions as needed to ensure treatment goals are met according to evidence-based standards.
- Mobilizes necessary resources to ensure timely patient testing and imaging, aiming to meet clinical goals and outcomes.
- Collaborates with clinical staff to develop individualized education plans or initiate patient education based on learning and continuing care needs.
- Conducts timely admission and continued stay reviews to determine medical necessity and the appropriate level of care, utilizing secondary reviewers as needed (Med/Surg and Birthing Suite).
- Communicates with physicians, clinical staff, and Patient Financial Services to ensure documentation supports the level of care.
- Applies knowledge of reimbursement principles and monitors financial outcomes to assess potential cost-reduction opportunities.
- Maintains expertise in state and federal regulations, including Hospital Issue Notices of Non-Covered Services (HINN), and issues notices as appropriate.
- Coordinates with Patient Financial Services to ensure proper precertification and/or preauthorization for admission and continued stay certification.
- Assists in the development, revision, and implementation of utilization review policies and procedures.
- Supports and evaluates the Swing Bed Program in line with current regulations, including reviewing internal and external referrals and facilitating team coordination.
- Supports and evaluates case management needs across the organization, such as in the Birthing Suite and Emergency Department, and serves as a Case Management resource.
- Uphold the values of MCH: Compassion, Collaboration, Honesty, and Respect.
Requirements:
- Must access and review email correspondence throughout the day and connect to scheduled meetings via ZOOM with full participation expected.
- Graduate of an accredited school of nursing as a RN. BSN preferred.
- Minimum of five years’ acute care nursing experience, one year of case management, discharge planning and/or utilization review experience required.
- Current NH RN License.
Additional Competencies and Skills:
*Candidates may acquire these skills through on-the-job training*
Proficiency with Microsoft products such as Word, Excel, PowerPoint.
Working Hours:
This is a full time M-F position.
Salary:
Competitive salary based on experience.
About Our Benefits:
Amazing people deserve amazing benefits.
We strive to employ and retain the most highly qualified individuals by providing equitable wages and benefits, promoting from within, and supporting the continuing education efforts of our staff.
You will be valued and rewarded for the work you do here with excellent pay and outstanding benefits. At MCH, you’ll find great opportunities for career advancement as well as personal and professional growth.
Full-time employees enjoy:
- Health insurance
- Dental insurance
- Vision coverage
- Flexible spending accounts
- Life insurance
- Short and long-term disability insurance
- Accident and Critical Illness insurance
- Identity theft insurance
- Retirement savings plan
- Lifestyle spending account
- Free membership to local gym
- Generous paid time off plans
- Opportunities for professional development and training
- Positive work environment with a supportive team and opportunities for growth
- Scholarship Opportunities
- Tuition reimbursement
Apply Now! or click the Apply button above.
About Monadnock Community Hospital:
Reach new heights at Monadnock Community Hospital.
MCH is a critical access hospital in beautiful, historic Peterborough, New Hampshire.
For 100 years, we have provided outstanding care to our communities, earning a reputation for excellence that has made us one of New Hampshire’s most successful and beloved small hospitals.
Join a culture of Compassion, Collaboration, Honesty, and Respect!
Our employees are the heart and soul of Monadnock Community Hospital.
In every department and at every level, MCH employees go above and beyond to deliver an exceptional patient experience in an atmosphere that is healthy, friendly, respectful, and personally fulfilling.
Experience
Required
- Computer skills with demonstrated knowledge of Microsoft Office including Outlook and Excel.
- Minimum of five years acute care nursing experience, one year of case management, discharge planning and/or utilization review experience required.
Preferred
- Knowledge of performance improvement principles, tools and techniques.
- Case Management certification required or willingness to obtain within two years.
Education
Preferred
Licenses & Certifications
Required
Skills
Required
