RN Case Manager

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POST DATE 9/15/2016
END DATE 10/16/2016

HCA Healthcare Salt Lake City, UT

Location
Salt Lake City, UT
AJE Ref #
576180730
Job Classification
Full Time
Job Type
Regular
Company Ref #
00954-32906
Experience
Entry Level (0 - 2 years)
Education
Bachelors Degree

JOB DESCRIPTION

Job Code: 00954-32906

Full-time

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