What are the responsibilities and job description for the Health Care Utilization Review Coordinator position at uic?
Position Summary
The HURC II is accountable for coordinating and facilitating patient services across the various levels of contium utilizating relationship-base care model as the framework. The HURC II takes initiative to improve patient outcomes by integrating Shared Leadership, Evidence Based practice and Magnets Five Models of Care into clinical practice. Through therapeutic relationships with patients families, self and their families in navagating through health care system based on individual patient population needs. In addition to the care facilatation, the HURC II will perform related duties including Utilization management aspects of securing and validating payor authorizations for clinical services which support the care continum and fulfills unit and organizational goals.
Duties & Responsibilities
Provides utilization management functions for patients: pre-certification (primarily a function of the Admissions Department), Continued stay reviews and retro-reviews.
Applies approved utilization acuity criteria to monitor appropriateness of CLOC and continued stays and documents finding based on department standards.
Assist physicians with determining CLOC and medical necessity. Facilitates appropriate clinical level of care determination and conversions if necessary.
Responsible for notification to the Admissions Department of CLOC conversions.
Monitors internal and external UR guidelines for patients in assigned units or departments. Com-municates key UM information to units and attending physician or their representative and man-aged care companies.
Inputs and maintains utilization management data into computer system. Perform other related duties and participate in special projects as assigned.
The HURC II is accountable for coordinating and facilitating patient services across the various levels of contium utilizating relationship-base care model as the framework. The HURC II takes initiative to improve patient outcomes by integrating Shared Leadership, Evidence Based practice and Magnets Five Models of Care into clinical practice. Through therapeutic relationships with patients families, self and their families in navagating through health care system based on individual patient population needs. In addition to the care facilatation, the HURC II will perform related duties including Utilization management aspects of securing and validating payor authorizations for clinical services which support the care continum and fulfills unit and organizational goals.
Duties & Responsibilities
