Job Type: Per Diem
Job Shift: Days
Holiday Rotation:
Department: Behavioral Health
Reporting to the Director of Case Management, the Utilization Review Nurse is responsible for ensuring that patients being admitted to Doctors Behavioral Health Center are admitted to the appropriate level of care in accordance with the vision and goals of Doctors Medical Center and the regulatory guidelines as set by the state and federal rules. The Utilization Review Nurse ensures quality, cost-effective patient care through planning; communication, critical thinking and facilitation of the multi-disciplinary patient care team. Coordinates Utilization Review activities to ensure that authorizations are obtained for in-patient acute hospitalizations. Acts as a liaison between MD’s, the Treatment Team and External Review Organizations. Reviews the Treatment Plan and monitors the delivery of care to make sure the desired treatment outcomes are achieved.. Communicates reimbursement issues, trends and patterns to the Director of Case Management and the Administrator.
Job details are sourced from the employer's original posting.
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Tenet Healthcare Corporation is a diversified healthcare services company.