…of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner. LDH serves as a

…including health policy assessment; access to and disparities in healthcare utilization ; the economics of healthcare; health insurance and healthcare financing;

…and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with

Job Summary + The Medical Records Utilization Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client

…**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials,

…**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials,

…+ Experience with managed care. + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs. + At

…Duties may include but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and

…and collaborates with interdisciplinary team to assure timely discharge. * Maintains an average Utilization Review (UR) accuracy rate at or above the goal. *

…and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of