Previous hospital case management and/or utilization review experience REQUIRED.
Availability to work weekends is a plus.
Must have RN License to do utilization review work.
Hours: Primarily Day/Evening hours - Not overnight
Patient-focused coordination, negotiation, and procurement of necessary resources to address all identified areas of need for facilitation of achievement of quality, cost-effective outcomes. Acts as a patient advocate through collaboration with the patient and the integrative staff, internal and external to the organization. Through this collaboration, the individual's needs are assessed, goals formulated, and a plan of care implemented, monitored, evaluated and modified for positive outcomes. Actively participates in quality improvement and performance improvement processes related to the management of patient care and safety, and utilization of healthcare resources.
Required Minimum Knowledge, Skills, and Abilities (KSAs)