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3 years' experience in community health, complex pediatric patient care, home care, case management, managed care or utilization review preferred Company Profile Since 1954, Texas Children's has been leading the charge in patient care, education and research to accelerate health care for children and women around the world.
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Minimum of two years of recent experience in Utilization Review, Quality, or Care Management preferred. The Care Coordinator works in partnership with the patient and/or care partner(s) to develop a comprehensive, individualized transitional care plan.
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Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator). The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
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Compile data for utilization management review and submit the data to the Concurrent Review nurse team for clinical decision-making. The Concurrent Review Coordinator is responsible for working with a multi-disciplinary team, serving primarily in an administrative support capacity.
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Completes patient team conference forms thoroughly Collaborates with unit director, infection control coordinator and utilization review regarding clinical nursing issues. Completes patient team conference forms thoroughly Collaborates with unit director, infection control coordinator and utilization review regarding clinical nursing issues.
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Coordinates, identifies, and/or initiates significant change MDS’ Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator Remains current with the American Association of Nursing Assessment Coordinators (AANAC) requirements.
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Utilization Review Coordinator. Registered Nurse, LPN or Master's level Social Worker with experience in Utilization Management, preferred. is an 84-bed treatment facility, conveniently located in beautiful central Jacksonville, FL that specializes in the successful treatment of substance abuse and mental health issues for youth, adults and seniors.
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Monitors and coordinates the implementation of a corrective action plan for deficiencies identified through utilization review, clinical record review, Medicare claim denials, patient satisfaction surveys, State or Federal surveys, and the Performance Improvement Plan.
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The Operations Coordinator is also in charge of dispatching and communication functions to effect economical utilization of vehicle facilities. Job Seekers can review the Job Applicant Privacy Policy by clicking HERE. (-applicant-privacy-policy) Job Summary: The Operations Coordinator plans, directs, and controls vehicle scheduling, allocation.
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What You’ll Do:Supervises the daily operations of the Utilization Review RN case management staff to meet department objectives of determination and coordination of appropriate plans of care, discharge planning, documentation, referrals, and care facilitationProvides direct support to Utilization Review staff for daily responsibilities.
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Collaborates with the Utilization Review Specialist RN regarding medical necessity of inpatient admission, appropriate patient class and duration of hospitalization. Maintains knowledge of current concepts, research needs and research strategies related to case management, utilization review and discharge planning.
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Three to five years of clinical experience as a Registered Nurse, including at least two years performing utilization review, charge audit, case management or similar functions in an acute care or specialty hospital.
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CARE COORDINATOR , is responsible for performing assessment and reassessment of behavioral health inpatients for the purpose of performing utilization review, resource management and discharge planning.
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This involves coordinating and collaborating with other services and agencies such as the Conservator’s Office, eligibility workers, Public Defender, Public Guardian, Court Services, Third Party Utilization Review Departments, and multiple County Mental Health Services system of care entities.
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Title(s) of Direct Report(s): Facilities Service Administrator, Facilities Service Coordinator, Data Entry Clerk, Supply Warehouse Specialist, Custodial Supervisor. Develop long- and short-term planning, asset control, and resource utilization for CFS.
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