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Essential Duties & Responsibilities including but not limited to:1) Performs utilization review and discharge planning to inpatient admissions. 2) Applies Interqual, AEP and or other review criteria approved by the Clinic to accurately determine appropriateness for inpatient and outpatient care.
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Monitors medical necessity of admissions, continued hospitalization, and surgical procedures using criteria approved by the medical staff and evaluates appropriate level of care for patient and notified the Utilization Review staff of necessary changes Utilizes principles of quality improvement in every aspect of performance by participating in unit and organizational quality improvement activities to develop strategies to reduce or resolve variations in practice.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
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Mobile Health Team Inc., a staffing agency has an opening for an RN - Utilization Review Case Manager. Mobile Health Team Inc., staffing agency has openings for UTILIZATION REVIEW CASE MANAGER.
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Performs utilization review of continuous care and inpatient levels of care for all patients on team. Monitors the type and level of team services provided (staffing, medications, HME, supplies, level of care changes to inpatient and continuous care, etc.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Actively review utilization patterns and appropriateness in areas such as emergency department charges, specialist consultations, downstream utilization of limited access and high utilization medical resources from both a physician and supportive/ancillary services.
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When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate.
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Utilization review, case management, discharge planning experience. The Case Manager advocates for the patient and family and collaborates with the health care team to facilitate appropriate movement along the continuum of care from inpatient admission to discharge.
$51.94 - $89.38 an hourFull-timeExpandUpdated 9 days ago - UpvoteDownvoteShare Job
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O Ensures updates and maintenance of hospital plans is completed (for example Plan for the Provision of Care/Scope of Services, Leadership, Information Management, Utilization Review, Infection Control, Performance Improvement and Patient Safety.
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Monitors utilization of resources by every patient to assure cost effective delivery of services. Participates in the Outcomes Management and annual program review. Collaborates with both the team physician and the attending physician regarding palliative care measures for pain and symptom management.
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Detailed knowledge of federal and state hospital Utilization Review (UR) regulations, Medicare Conditions of Participation, Medicare Guidelines regarding Medical Necessity, Hospital Admission and Hospital stays.
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Supports discharge planning and utilization review services within a multidisciplinary treatment team in the Senior Behavioral Health Unit. Complete utilization review in an organized and timely manner.
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As a national leader in post-acute care, Encompass Health (NYSE: EHC) offers facility-based patient care through its network of inpatient rehabilitation hospitals. o Coordinates the review, revision, development, approval, and implementation of hospital specific policies.
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Knowledge of the principles and practices of primary medical and nursing care, with at least a working knowledge of oncologic nursing and palliative care. Basic understanding of the interpersonal dynamics operative within the working relationships of an interdisciplinary health care team, and knowledge of the process of dying and bereavement.
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Assists the physician as follows, but not limited to Utilization Review, Quality Assurance, Program Evaluation, Infection Control, and Safety Committee activities. Experience: Ideal candidate will have 2+ years of post-cardiology Physician Assistant/Nurse Practitioner experience in both inpatient and outpatient.
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Inpatient only; All inpatients requiring utilization review & discharge planning. EMR: Cerner & Interqual for Utilization Review. Specialty: Case Management (Utilization Review.
ExpandApply NowActive JobUpdated 1 month ago
utilization review inpatient jobs
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