…case management plan. + Provide clinical support to the case management and utilization review team for training, policy and procedures, and quality assurance

…Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager

…Engage in the teaching, consulting and advising of the care management and utilization review departments and hospital leadership. + Collaborate with a

…necessarily performed by each individual in the classification. 1. Coordinates all utilization review functions, including response to payor requests for

…Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory

…of Science in Nursing Prefer at least one year experience in utilization review , resource management, discharge planning or case management. Methodist

…utilization management. Knowledge of federal, state and local regulations affecting the utilization review program and payment as well as current knowledge of

…and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan

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

…the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages specific conditions. +