Lutheran Hospital - Utilization Review - Clinical Specialist
Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures that an authorization for services is obtained from payer, if required, and that documentation supports the care delivered in such a way that minimizes the risk of denials after discharge.
Benefits
Medical, Dental, Vision, Basic Life and Accidental Death & Dismemberment (AD&D), Supplemental Life and AD&D, and Dependent Life and AD&D Insurance.
Requirements
Associate Degree in Nursing required. Bachelor's or Master's Degree in Nursing preferred. Minimum of three years of nursing experience. Three or more years of prior utilization review or case management experience preferred.
Lutheran Hospital (Utilization Review)
Education: ADN
PT (16 hours per week)
Title: Case Manager