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Coordinates and manages the care of complex patients to facilitate achievement of quality patient outcomes. Performs utilization functions for appropriateness of admissions and continued hospital stay. Communicates with third-party payors, as needed, to assure reimbursement. Communicates appropriately with other care givers as needed.


JOB SPECIFIC RESPONSIBILITIES:

•Screen admissions each day to identify appropriate level of management required for each
patient for the service area covered. Review new admissions, applying medical necessity
criteria, and develop an anticipated discharge date for the assigned units/rooms.
• Prepares to discuss patients with length of stay greater than 20 days and difficult discharges
with the Managed Care Committee members on Wednesdays.
• Assist and ...