What are the responsibilities and job description for the Utilization Review position at Nevada Regional Medical Center?
Essential Functions:
- Authorize patient stays
- Submit insurance PA for hospital admission insurance.
- Continued stay submissions
- Discharge submission to insurance
- Appeals and Peer to Peer submission
- InterQual submission for medical necessity.
- Discharge planning for BHU and Acute Care.
- Conduct UR Committee.
- CDI Management
- Swing Bed intake process
- All other duties within the scope of practice.
Working Conditions:
- Possible exposure to inside environmental conditions.
- Exposure to distressed patients, families or visitors.
Physical Demands:
- Requires standing, sitting or walking for up to 8 hours or longer per day.
- The ability to lift up to 50 lbs.
Requirements:
- Graduate of an Accredited School of Practical Nursing or Registered Nursing or Graduate of an approved program in Respiratory Care or BSW/MSW from accredited school of social work required or similar education and experience; Missouri licensure preferred
