Functions of Position: Performs admission, concurrent and focused reviews using severity of illness/intensity of service criteria to ensure effective utilization management. Refers unjustified cases to physician advisor following hospital U.R. plan. Collects and analyzes data to assure that quality and cost effectiveness issues are addressed for enhancement of patient care and Q.I./R.M./U.R. activities. Maintains daily and monthly work log and/or abstracts on all reviews to ensure appropriateness of utilization review activities. Prepares reports, graphs, and statistical data for reporting through committee structures. Collaborates with physicians, nurses, and other health care personnel to ensure effective utilization management. Communicates with state PRO, insurance companies and other third-party organizations to ensure appropriate utilization of resources. Qualifications: ▪Must have graduated from an approved school of nursing. ▪Must have a registered nurse license. ▪Must have a valid registered nurse license to work in the state of Missouri. ▪Must have a minimum of 2-3 years of experience in a related field. ▪This is an on-site job at Missouri Delta Medical Center, no remote eligibility with this position. Monday - Friday 8:00am - 4:30pm
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Job Type
Full-time
Education Level
No Education Listed