RN Utilization Review

RN Utilization Review

Location:

Portales, NM

Job Type: Travel

Discipline: RN

Speciality:
Utilization Review

Facility Setting:
Short Term Acute Care (STAC)

Accepting Locals per Radius Rule?:
Yes

Contract Length: 13 weeks

Shifts:

Days

Shift Details:
Day 5x8-Hour

Weekly

Schedule:

40 Hours

Certifications/License:

Mandatory

Experience:

• Routine case management, discharge planning, swing bed coordinator and utilization review duties.
• Evaluating and screening potential admissions to the facilities swing bed program
• Knowledgeable of criteria for Medicare, Medicaid, HMO, swing bed and private insurance coverage
• Initiate ongoing communication with the resident and resident's family to assess discharge needs.
• Actively involvement in daily rounds with bedside staff, physicians and ancillary team members
• Communicate with physicians to ascertain their plans for a timely discharge.
• Document updates and discharge planning as an ongoing review.
• Manage and collaborate with the healthcare team on swing bed placement and complete MDS documentation as necessary.
• Assist with obtaining referrals, prior authorization for Home Health Care, CME, SNF, acute rehab and appointments.
• Educates physicians and staff regarding appropriate level of care/utilization and required documentation that meets admission status
• Run Interqual for each IP and OBS patient admitted to the floor

Get in Touch:

We want to hear from you! If you think you'd be a good match, submit your resume and reach out to Shrishti at  to learn more.