Description
This position is responsible for reviewing all admissions for appropriateness and continued stay. Communicate with nursing, ancillary departments and physicians. Completes inpatient and observation chart review for all insurance types in a timely manner. Documents completely and accurately all information obtained during chart review that is pertinent to the utilization review and payment processes utilizing qrs. Work with patients and families on discharge planning.
Qualifications
Education: BSN preferred.
Requirement: At least 3 years of Case Management experience. 3 years clinical nursing experience preferred. Knowledge of Medicare, medical regulations and interqual criteria. RN license and BLS required
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