Role OverviewConducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.
What You Will Do
Conducts admission concurrent and retrospective case reviews, performs patients' medical record reviews, communicates with third-party payors, and implements strategies to avoid potential denials.
Why It Might Be a Fit
The ideal candidate will have acute Utilization Review experience, excellent problem-solving skills, and strong verbal and written communication skills.
Requirements
- Associate's degree in Nursing
- 3-4 years experience in acute care setting
- 1-2 years experience in case management, insurance UR, or related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure
- CCM - Certified Case Manager
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