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 :

Job Tags

Shift work, Monday to Friday,

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