The Utilization Review Registered Nurse (Case Manager) will be responsible for monitoring adherence to the hospital’s utilization review plan as well as appropriateness of hospital admissions and extended stays by completing inpatient medical reviews ensuring medical necessity of all hospital admissions. Performs concurrent reviews for patients to ensure that extended stays are medically justified and are so documented in patient’s medical records. Coordinate with the multidisciplinary team via interdisciplinary rounds for status changes, plans of care and complete PRIs for short-term rehab or long-term placement.
NYS RN license required. Previous Med/Surg and Utilization Review/Case Management experience preferred.