Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings. Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care. Conduct discharge planning.
, EXT. 229
RN, registered nurse, case manager, discharge planning, acute care, managed care, triage, quality assurance, telehealth, telephonic, health plan, utilization review, prior authorization, quality improvement, utilization management, HMO, PPO, concurrent review, Medicaid, Medicare, care manager, utilization review, acute care, clinical, CCM, certified case manager, healthcare, medical, BSN, bachelor degree