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RN Utilization Review

Hired by Matrix

Job Title: RN Utilization Review
City: Portales
State: NM
Job Type: Travel
Discipline: RN
Speciality: Utilization Review
Facility Setting: Short Term Actut 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 View phone number on click.appcast.io to learn more.
Vacancy posted 4 days ago
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