…guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality

…and records; manages priorities effectively; participates in Performance Improvement, Utilization Review and other professional activities in accordance

…guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality

…trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends

…ED inpatient admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance

…UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient services,

…and in ensuring appropriate data elements are included in the POC. + Review visit utilization for appropriateness as per care guidelines, best practices,

…and submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on

…are not limited to the following: Coordinating with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization

…to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care