Ultilization Review Coordinator FT Days 1.0*
Description:
Utiliztion Review/Case Management Coordinator FT Days
Plantation, Fl
Responsible for the implementation of the review process. Monitors
physician documentation for appropriateness of hospitalization,
identifies and evaluates quality of care, infection control, safety
hazards, potential risk management and utilization problems.
Reports findings to appropriate people. Responsible for assessments,
continued reviews and coordination of discharge planning activities.
This is accomplished by conferring with all parties involved and
identifying options. To implement the Utilization Review process on
all hospital admissions. To conduct continued stay review, patient
evaluation and to coordinate discharge planning activities with
patients of all ages. To monitor over-utilization and under-utilization
of services.
Qualifications:
Required Job Qualifications include:
1. Current Florida R.N. or L.P.N. Nursing license2. Knowledge of
Federal and State requirements: HCFA, Medicare, Champus,
Medicaid, AHCA, and HRS.3. Knowledge of managed care case
management functions.4. Active participation in professional groups
to keep updated on changes in regulations. Motivational skills and
awareness of position requirements.5. Participation in continuing
education.6. Healthcare related field experience.
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