Job Purpose/Duties:
The temporary Home Care Utilization Review Nurse will conduct clinical reviews of pediatric and young adult members for all inpatient stays, homecare, outpatient rehabilitative therapy, durable medical equipment and long term care services based on standardized criteria. Responsible for both the management of resources and the achievement of desired outcomes for members with ongoing communication to the Director of Care Management and Utilization Management, the Medical Director and staff for the development and coordination of the discharge plan and continued management of members. Maintains a cooperative relationship among health care teams by communicating information; responding to requests; building rapport; participating in team problem-solving methods.  Contributes to team effort by accomplishing related results as needed.

Skills/Qualifications:
Bachelor’s degree is required. Current licensure in the District of Columbia as an RN is required. The incumbent must be able to practice independently at the professional level. A minimum of one year of utilization review experience is required along with five years of clinical experience in pediatric nursing, care coordination and utilization management for target population Ability to simultaneously handle multiple complex assignments. Appreciation and sensitivity of cultural diversity. Professional decorum. Strong analytical, critical thinking and problem solving skills. Strong computer systems and applications skills required along with effective communication skills.

Clinical Skills, Bedside Manner, Infection Control, Nursing Skills, Physiological Knowledge, Administering Medication, Medical Teamwork, Multi-tasking, Listening, Verbal Communication, Health Promotion and Maintenance

Health Services for Children with Special Needs, Inc. (HSCSN) is an innovative care management network coordinating health, social, and education services for the pediatric Supplemental Security Income (SSI) and SSI-eligible populations of Washington, DC.