Job Summary:Performs Case Management activities to assure medical necessity of admissions and appropriateness of continued stay utilizing the Interqual Criteria guidelines. Monitors the utilization of resources of all patients reviewed. Maintains confidential communication with physicians and multi-disciplinary personnel to meet individual needs or the patients served. Functions as an independent contributor as well as a team member.Position Qualification:Possess three or more years of acute care hospital experience preferred.Familiar with the operations of the healthcare industry and healthcare delivery systems.Able to use the medical record in order to obtain clinical information to perform Interqual reviews.Utilize Outlook, and the computer-based systems (AllScripts) to perform reviews.Work experience in Medical-Surgical, Telemetry, Critical Care, and/or Pediatrics, NICU preferred.Required Licenses/Certifications:Current Florida RN Licensure BLS Certification.Must possess a solid clinical background to accomplish extensive Medical Record review.Computer skills preferred What Should I Know About Hialeah Hospital?Our 378-bed acute care hospital opened in 1951 to serve the Hialeah, Florida community. Our team is committed to honoring the trust that our patients place in us by providing compassionate, safe, high-quality care in the right place, and at the right time.Hialeah Hospital has been honored to receive a number of awards and designations for our superior health care services, including:CardiacAmerican Heart Association Get with the Guidelines - Heart Failure Gold Plus Award, 2018American Heart Association Get with the Guidelines - Target Stroke Gold Plus Award, 2018BariatricAmerican College of Surgeons/American Society for Metabolic and Bariatric Surgery - MBSAQIP Accredited CenterBCBS â€" Blue Distinction Specialty Care Bariatric Surgery, January 2018NeurologyAdvanced Primary Stroke Center Re-accreditation, April 2018Women's ServicesAmerican College of Radiology granted Stereotactic Breast Biopsy Re-accreditation, March 2016Hyperbaric UnitHealogics Center of Distinction Award, 2017Laboratory Services/Blood BankCertificate of Accreditation from College of American Pathologist