Job Description

Summary

Department: Utilization Mgmt

Shift timings: 7:3016:00 Monday to friday (5 Days/ 8 Hours)

Per Week: 40 Hours

ICU8beds Medical25 Surgical25 Meditech Preferred work in all above areas Use of MCG criteria Use of Interqual criteria

Roles & Responsibilities

• Concurrent review of patients clinical information for efficiency
• Ongoing review of precertification requests for medical necessity
• Monitor the activities of clinical and nonclinical staff
• Coordinates patients discharge planning needs with the healthcare team
• Employ effective use of knowledge critical thinking and skills to:
  • Advocate quality care and enhanced quality of life
  • Prevent patient complications during hospital stay
  • Advocate decreased hospital stay when appropriate
• Maintain accurate records of all patient related interactions
• Prepare monthly patient management and cost savings report
• Work in an intensive fastpaced environment with minimal supervision
• Ability to stay organized and interact well with others in any situation
• Provide daily updates to Manager of Utilization Management for review

Minimum Qualifications

• Bachelors degree in Nursing
• State licensure as a Registered Nurse (RN)
• Minimum 2 years of prior experience in Utilization Management
  

Required Skills

RN Utilization Review

Remote Work :

No

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