Job Description
Description - Coordinates care and services for particular population of patients including conducting utilization review, establishing proper admission status in conjunction with the physician, facilitating patient and/or family participation in decision making regarding treatment and overseeing discharge plans.
- Works collaboratively with providers to arrange post-discharge care and services in a timely manner, involving the patient and/or family in developing discharge plans.
- Conducts admission and continued stay reviews for medical necessity, severity of illness and intensity of service. Coordinates proper admission status with the physician and obtains authorization for reimbursement in a timely manner.
- Develop and maintain a collaborative team to evaluate and create process for denied authorizations in an effort to improve process and eliminate loss of revenue.
- Provide quality psychosocial needs to patients and their family by formulating a diagnostic impression.
- Provides efficient methods of work processing and workflow for the utilization function required with patient management.
- Oversight and coordination of all patients admitted to swing bed program.
- Complete initial review of potential swing bed patients, including appropriateness, review with accepting provider on call.
- Update polices on case management, utilization review and swing bed.
- Function effectively in an independent manner.
Requirements BLS required upon hire and maintained throughout employment. Master's degree in Social work or a graduate of an accredited school of nursing and currently licensed to practice in the State of Michigan. 2-3 years of case management and/or utilization review experience preferred. EATON RAPIDS MEDICAL CENTER
Job Tags
Casual work,