…With Us! (https://careers-primehealthcare.icims.com/jobs/182245/discharge-planner utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)

…nursing and inpatient rehab facilities, home health care, care management, and utilization review . The Registered Nurse is responsible for the implementation,

…and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and

…responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient

…a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in

… utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality

…review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and

…located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's Degree in Nursing

…clinical nursing required. Two years experience with case management, discharge planning, utilization review and/or home care required. Knowledge of the

…include care management, interpreting dental/medical policy, quality improvement, disease management, utilization review , and dental/medical claims review ,