Utilization Reviewer - RN Job
Job Description
Job Title: Utilization Reviewer - RN
Company Name: Piedmont Hospital
Employment Type: Full Time
Location: ATLANTA, GA, United States
Department: PATIENT CARE COORDINATION
Salary: Highly Competitive
Shift/Hours: Monday thru Friday
Hours/Pay Period: 80
Degree Required: State License
Job ID: 7170-P2112-013374
Date Posted: Nov 3, 2011
Years Experience: 2
Job Category: Professional Administration
Note: Please read the complete description below before applying for this job.
Complete Description
RESPONSIBLE FOR:
Performing admission reviews of pre-hospitalized and hospitalized patients. Knowledgeable of federal and state hospital Utilization Review (UR) regulations. Familiar with Milliman and Robertson guidelines, and has in-depth knowledge of Interqual criteria. Works with the Admissions Department to implement procedures for compliance with these regulations.
QUALIFICATIONS:
Graduation from an accredited School of Nursing with current Georgia licensure. Previous hospital experience in Utilization Review.
ESSENTIAL FUNCTIONS:
1. Engages in activities that promote proper utilization of the Hospital and its resources.
2. Obtains retroactive Medicaid certification.
3. Verifies appropriateness of Direct Admit transfers.
4. Verifies and processes patient accounts on the P-Type list using the Quic List .
5. Verifies and processes patient accounts on the P-Retro list using the Quic List.
6. Verifies and processes weekend review list.
7. Processes weekend admission census list.
8. Verifies Medicare prior day admits.
HOTJOB:20120113
Apply Here:Â http://www.piedmonthealthcare-jobs.com/job/ATLANTA-Utilization-Reviewer-RN-Job-GA-30301/1517930/?feedId=714&campaignId=34&utm_source=ADVANCE&utm_campaign=Piedmont_HotJobs&tcsource=apply
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