RN Case Manager
This job is no longer active. View similar jobs
Job Code: 00954-32906
Days (rotating weekends)
The Registered Nurse Case Manager performs activities focused on assessing medical necessity on all patient records, regardless of payer source. The RN Case Manager will perform clinical reviews on inpatient records using approved InterQual criteria to evaluate medical necessity, admission status, level of care and discharge needs.
The Case Manager is responsible for identifying and obtaining additional authorizations, facilitating authorizations for referrals, communicating with and accurately documenting communications with third party payers in accordance with facility policies and procedures. The Case Manager will initiate/escalate denial management activities concurrently, and serve as a liaison with the Patient Account Services (PAS) and others to minimize financial risk to the patient and facility.
* Current licensure as a RN in the State of Utah.
* BSN preferred.
* Five years nursing experience in acute care setting, Case Management and Utilization Review experience preferred.
Last Edited: 09/13/2016