with a payor on a case-by-case basis. This position integrates national standards for case management scope of services including...: Utilization Management services supporting medical necessity and denial prevention Coordinating with payors to authorize...
, electronic health records (EHR), database systems, and utilization review/case management documentation systems. Knowledge...Dedicated to Weekends - Saturday & Sunday from 8am-6:30pm Onsite Only GENERAL SUMMARY: The Case Manager-RN plays...
readmissions. This position integrates national standards for case management scope of services including: Utilization Management... and department orientation is required. Department orientation includes review and instruction regarding Tenet Case Management...
Should Have utilization management experience. Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing... required. Certification in Case Management may be preferred based upon designated department assignment. Above average computer skills...
, such as utilization review or managed care is helpful Strong interpersonal, time management, and organizational skills Computer... Current RN Licensure in state of operation Certification as a CCM, CIRS, or other Case Management certifications preferred...