Registered Nurse - RN Intake Coordinator

About the role

Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to payors ensuring proper reimbursement for care. In collaboration with members of the health care team, conducts observation, admission, concurrent, discharge and retrospective reviews to evaluate the appropriate level of care, continued stay, and status of discharge planning.

Responsibilities

• Perform all aspects of utilization review to ensure the medical necessity of acute care hospitalization has the existence of supportive documentation in the EMR
• Provide all external review organizations the information necessary to complete reviews and effect maximum financial reimbursement
• Collaborate with Case Management
• Provides consultation and information to physicians, case managers and other members of the health care team

Requirements

• Bachelor of Science in Nursing (BSN)
• Current State of Michigan Registered Nurse License
• Three years acute care as a RN

Preferred Qualifications

• Two years recent acute care utilization management experience
• Experience in facility audits/appears and processes
• Ability to work autonomously with little direction and be accountable for outcomes

Schedule

• Full time, 40 hours per week
• Night shift: 11:00 PM – 7:30 AM
• Remote