Utilization Management Review Nurse
Company: Memorial Health System
Location: Springfield
Posted on: January 8, 2021
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Job Description:
Overview:Performs clinical review of patient records to evaluate
the utilization of acute care services. Communicates to third party
payors to support the medical necessity of the hospital admission
for services reimbursement. Ensures the patient care team is aware
of general length of stay requirements for all patients.
Facilitates physician documentation through concurrent interaction
with physicians to support reimbursement and clinical severity is
captured for the service rendered to patients receiving hospital
care. Provides clinical knowledge and data collection for quality
improvement initiatives. Optimizes reimbursement for acute care
services.Qualifications:Education:
Keywords: Memorial Health System, Springfield , Utilization Management Review Nurse, Executive , Springfield, Illinois
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