RN Utilization Management - 37004714 Wollborg Michelson RecruitingRN Utilization Management - 37004714Little Rock, ARThe Utilization Management Nurse performs clinical review of prior authorizations, network exceptions, benefit inquiries, inpatient medical/surgical admissions, and outpatient procedures. Collaborate with healthcare providers and internal staff to promote quality of care, cost effectiveness, accessibility, and appropriate service levels.
NewUtilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantAR$26.01–$62.32 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Case Manager / Utilization Review Nurse Conway Regional Health SystemCase Manager / Utilization Review NurseConway, ARAn employee who is under the influence of Marijuana constitutes a threat to patients/customers which Conway Regional is responsible for in providing and supporting the delivery health care related services. Registered Nurse or Licensed Practical Nurse with current, active license to practice in Arkansas, required.
NewUTILIZATION EXPERT - RN - WEEKENDS St Bernards HospitalUTILIZATION EXPERT - RN - WEEKENDSJONESBORO, ARWorks closely with the physicians, allied health nurses, and coding department to facilitate clinical documentation program. Work closely with case management staff to ensure level of care change is communicated and flows smoothly.
NewUtilization Review Nurse CommonSpirit HealthUtilization Review NurseLittle Rock, ARThey work in close collaboration with physicians and other members of the healthcare team to optimize patient outcomes by ensuring access to the right treatment utilizing available hospital resources in the most cost-effective manner. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Case Manager / Utilization Review Nurse Conway Regional Heath SystemCase Manager / Utilization Review NurseConway, ArkansasFull timeAn employee who is under the influence of Marijuana constitutes a threat to patients/customers which Conway Regional is responsible for in providing and supporting the delivery health care related services. Qualifications: Registered Nurse or Licensed Practical Nurse with current, active license to practice in Arkansas, required.
NewUtilization Review Associate ARCAREUtilization Review AssociateAugusta, AREligible clinical team members may qualify for federal loan repayment programs through HRSA, including the National Health Service Corps Loan Repayment Program and the Nurse Corps Loan Repayment Program. Whether caring for patients in the clinic, supporting operations behind the scenes, or serving communities through outreach and education, our teams are united by a shared purpose: delivering compassionate, accessible care that improves lives.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerLittle Rock, ARRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Utilization Specialist Acadia Healthcare Co IncUtilization SpecialistConway, ARLICENSES/DESIGNATIONS/CERTIFICATIONS: ?Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. ?Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
Utilization Specialist Conway Behavioral HealthUtilization SpecialistConway, ArkansasPer diemGather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. Preferred Licensure : LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
Case Management Director Encompass Health Rehabilitation Hospital of Fort SmithCase Management DirectorFort Smith, ARFull timeJoin us in this journey of care, compassion, and leadership as we work together to make a difference where it matters most, serving as a key member of our leadership team overseeing the day-to-day operations and management of our Case Management department. - Oversee the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services with a central focus on census management, patient care outcomes, and key care indicators.
Nurse-Navigator RN: Cancer Center Baptist Memorial Health CareNurse-Navigator RN: Cancer CenterJonesboro, ARProvide individual patient/family education and self-management support that is appropriate based on language, cognitive abilities, literacy level, learning style, cultural norms, patient preference, readiness for change and resources available. Assist with and facilitate the transition of care from inpatient settings such as hospital, rehabilitation facilities and skilled nursing facilities to home.
Director Case Management Howard Memorial HospitalDirector Case ManagementNashville, ARCoordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies, and healthcare facilities. ResponsibilitiesProvides case management/utilization review and discharge planning to assure that the patient progresses through the continuum of care and is discharged to the least restrictive environment.
Case Management Director Encompass Health CorpCase Management DirectorFort Smith, ARJoin us in this journey of care, compassion, and leadership as we work together to make a difference where it matters most, serving as a key member of our leadership team overseeing the day-to-day operations and management of our Case Management department. Oversee the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services with a central focus on census management, patient care outcomes, and key care indicators.
Director Case Management LifePoint Health IncDirector Case ManagementHot Springs, AROur diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. National Park Medical Center is a 163 bed hospital located in Hot Springs, Arkansas, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Little Rock, ARRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Hospice Nurse Practitioner Gentiva HospiceHospice Nurse PractitionerMena, ArkansasComplete all visit types for patients on services, including Medicare-required hospice Face-to-Face (F2F) visits within CMS established regulatory timeframes, History & Physical/Initial Comprehensive visits, Problem-focused Symptom Management visits, Admission visits, Goals of Care discussions, and routine follow up visits. The Nurse Practitioner will deliver advanced clinical care, perform patient management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with physicians and interdisciplinary teams to ensure high-quality, compliant, and compassionate care.
Case Manager / PRN ( RN / RT / SW / LPN ) Regency Hospital - NW Arkansas SpringdaleCase Manager / PRN ( RN / RT / SW / LPN )Springdale, ArkansasResponsibilities: We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right. Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery.
DIR - CLINICAL SVCS - BH (RN or LCSW) University Health Services IncDIR - CLINICAL SVCS - BH (RN or LCSW)ARProvide clinical oversight for behavioral health programs, ensuring patient safety, quality outcomes, and evidence-based practices Develop, implement, and evaluate behavioral health services, programs, and treatment models In coordination with the Hospital, Ensures compliance with federal, state, and accrediting agency regulations (e.g., CMS, Joint Commission, state licensing agencies) Collaborate with medical, nursing, and ancillary leadership to integrate behavioral health services across care settings Directs departmental staff involved in multidisciplinary teams to address process improvements involving patients, employees, other customers or teams appropriately Defines the philosophy, goals and objectives of the treatment program under the direction of hospital administration, Horizon's clinical and operations staff and in conjunction with the Medical Director Works with divisional and national support staff to ensure that the client hospital realizes maximum value from Horizon services. Qualifications: Bachelor of Science in Nursing (BSN) or Licensed Clinical Social Worker (LCSW) required Master's Degree (Healthcare Administration, Psychology, Social Work, Nursing, or related) preferred Strong license and strong regulatory background, leadership skills and staff development experience Excellent clinical psychiatric knowledge base and understanding of programming Must have 5 to 8+ years of related work experience American Heart Association issued BLS and ACLS required CPR Certification.
Case Manager / PRN ( RN / RT / SW / LPN ) Select Medical CorpCase Manager / PRN ( RN / RT / SW / LPN )Springdale, ARWe are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right. Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery.
Regional Infusion Nurse Manager ARCARERegional Infusion Nurse ManagerFayetteville, ARThis role ensures high-quality patient care, regulatory compliance, staff development, and operational efficiency while supporting organizational goals and maintaining exceptional patient outcomes. The Regional Infusion Nurse Manager provides clinical, operational, and leadership oversight for infusion services across multiple locations.
LPN Part-time (Saturday & Sunday) Methodist Children's Behavioral HospitalLPN Part-time (Saturday & Sunday)Jonesboro, ArkansasWhen an employee performs two or more different jobs, for which different straight time hourly rates are established, the employee will be paid during overtime hours at a rate not less than one and one-half time the hourly rate established for the type of work he or she is performing during the overtime hours. Must be able to use a telephone to communicate verbally and a computer to communicate through written means, to review information and enter/retrieve data, to see and read characters on a computer screen, chart or other treatment items.
Registered Nurse (RN) Joint Program Coordinator LifePoint Health IncRegistered Nurse (RN) Joint Program CoordinatorBenton, AROur diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. In conjunction with the physician, implements care/treatment plan by coordinating the episode of care for joint replacement surgery patients across multiple providers/disciplines, ensuring patient continuum of care services and monitoring outcomes.
Registered Nurse UnitedHealth Group IncRegistered NurseMena, AR$37–$55.50 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Makes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation.
Travel PPV RN Judge GroupTravel PPV RNHarrison, AR$52–$55 / yearBy providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. scheduled visits, and schedule changes to scheduler, orders and OASIS data sets, coding.
RN Charge NICU Community Health Systems IncRN Charge NICUJohnson, ARThis role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development. Job Summary The RN Charge oversees the operations of a nursing unit during assigned shifts, ensuring effective and efficient delivery of high-quality patient care.
RN Charge Med Surg Community Health Systems IncRN Charge Med SurgSpringdale, ARLicenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure required BLS - Basic Life Support required * ACLS - Advanced Cardiac Life Support preferred. This role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development.
RN Charge Women's Services Community Health Systems IncRN Charge Women's ServicesBentonville, ARThis role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development. The RN Charge oversees the operations of a nursing unit during assigned shifts, ensuring effective and efficient delivery of high-quality patient care.
RN Charge Med/Surg Community Health Systems IncRN Charge Med/SurgBentonville, ARThis role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development. The RN Charge oversees the operations of a nursing unit during assigned shifts, ensuring effective and efficient delivery of high-quality patient care.
RN ER Charge Nights Community Health Systems IncRN ER Charge NightsSiloam Springs, ARThis role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development. The RN Charge oversees the operations of a nursing unit during assigned shifts, ensuring effective and efficient delivery of high-quality patient care.
RN Case Manager CommonSpirit HealthRN Case ManagerLittle Rock, ARFacilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative and post acute care providers in accordance with the patients clinical or psychosocial needs, choices and available resources. Every day, you will strategically assess, plan, and facilitate comprehensive care across the continuum, expertly advocating for patients while collaborating with physicians, nursing, departments, insurers, and post-acute providers to ensure timely, high-quality transitions.
Clinical Services Specialist RN AFMCClinical Services Specialist RNFort Smith, ARReview each selected record accurately and according to AFMC, state and federal policies and procedures.\ 2. Function as a resource for non-clinical staff by providing oversight and follow-up for clinical related questions or issues\ 3. Write effective and accurate review summaries and submit within appropriate time frame.\ This job was posted by https://www.arjoblink.arkansas.gov : For more information, please see: https://www.arjoblink.arkansas.gov/jobs/4776285 **SCOPE OF POSITION:**\ Responsible for analyzing patient records to determine legitimacy and necessity of medical services in compliance with government reimbursement policies.
Licensed Practical Nurse (LPN) I Arkansas Children's Hospital NorthwestLicensed Practical Nurse (LPN) ILittle Rock, ArkansasCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/ )and search the "Find Jobs" report. Emergency Department, Part Time, 11a-11p, Thurs/Fr and Tues/Fri Additional Information: The Licensed Practical Nurse (LPN) collects patient/family information that assists the Registered Nurse in assessment, planning, implementation, and evaluation.
LPN II Pine Bluff Clinic Arkansas Children's Hospital NorthwestLPN II Pine Bluff ClinicPine Bluff, ArkansasCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/ )and search the "Find Jobs" report. 1. Collects patient/family data to facilitate the identification of clinical, educational, psychosocial, and cultural needs and communicate data and observations to health team members.
RN Case Manager Blue Cross and Blue Shield AssociationRN Case ManagerARESSENTIAL ABILITIES & SKILLS Independence Detail oriented Skills Administrative Process Affinite CM Affinite UM CCI Edits Collaborative Communications Critical Reasoning Cross-Functional Planning Customer Relationship Management (CRM) Customer Service Workstation Deductive Reasoning Five9 Information Security Interpersonal Relationship Management Microsoft Excel Microsoft Office Microsoft Outlook Microsoft PowerPoint Needs Assessment Oral Communications Problem Sensitivity Researching Sound Judgment Support Coordination Written Communication Responsibilities Assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet an individual's health needs through the use of plan benefits and community resources to facilitate appropriate cost effectiveness and cost containment measures are met. Certifications Accredited Case Manager (ACM) - American Case Management Association (ACMA), Certified Case Manager (CCM) - The Commission for Case Manager Certification (CCMC), Registered Nurse (RN) - Arkansas State Board of NursingArkansas State Board of Nursing Security Requirements This position is identified as level three (3).
RN Case Manager Bilingual (English/Spanish) Blue Cross and Blue Shield AssociationRN Case Manager Bilingual (English/Spanish)ARThis role focuses on quality patient outcomes and cost-effective healthcare delivery and may encompass general medical case management or specialize in high-acuity areas and/or high-cost areas such as high-risk obstetrics and neonatal care, chronic disease management, and/or mental health support (excludes Behavioral Health). Serves as a liaison facilitating a collaborate process which includes patients, families/caregivers, physicians, hospital discharger planners, home care providers and other ancillary providers to promote quality of care, cost effectiveness, accessibility and appropriateness of service levels.
RN Case Manager Bilingual (English/Spanish) Arkansas Blue CrossRN Case Manager Bilingual (English/Spanish)ArkansasAdministrative Process • Affinite CM • Affinite UM • CCI Edits • Collaborative Communications • Critical Reasoning • Cross-Functional Planning • Customer Relationship Management (CRM) • Customer Service Workstation • Deductive Reasoning • Five9 • Information Security • Interpersonal Relationship Management • Microsoft Excel • Microsoft Office • Microsoft Outlook • Microsoft PowerPoint • Needs Assessment • Oral Communications • Problem Sensitivity • Researching • Sound Judgment • Support Coordination • Written Communication Responsibilities. This role focuses on quality patient outcomes and cost-effective healthcare delivery and may encompass general medical case management or specialize in high-acuity areas and/or high-cost areas such as high-risk obstetrics and neonatal care, chronic disease management, and/or mental health support (excludes Behavioral Health).
RN Case Manager Arkansas Blue CrossRN Case ManagerArkansasAdministrative Process • Affinite CM • Affinite UM • CCI Edits • Collaborative Communications • Critical Reasoning • Cross-Functional Planning • Customer Relationship Management (CRM) • Customer Service Workstation • Deductive Reasoning • Five9 • Information Security • Interpersonal Relationship Management • Microsoft Excel • Microsoft Office • Microsoft Outlook • Microsoft PowerPoint • Needs Assessment • Oral Communications • Problem Sensitivity • Researching • Sound Judgment • Support Coordination • Written Communication Responsibilities. This role focuses on quality patient outcomes and cost-effective healthcare delivery and may encompass general medical case management or specialize in high-acuity areas and/or high-cost areas such as high-risk obstetrics and neonatal care, chronic disease management, and/or mental health support (excludes Behavioral Health).
LPN II West Little Rock Clinic Arkansas Children's HospitalLPN II West Little Rock ClinicARCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/)and search the "Find Jobs" report. Collects patient/family data to facilitate the identification of clinical, educational, psychosocial, and cultural needs and communicate data and observations to health team members.
Licensed Practical Nurse (LPN) I Arkansas Children's HospitalLicensed Practical Nurse (LPN) ILittle Rock, ARCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/)and search the "Find Jobs" report. Collects patient/family data to facilitate the identification of clinical, educational, psychosocial, and cultural needs and communicate data and observations to health team members.
NewLPN II Pine Bluff Clinic Arkansas Children's HospitalLPN II Pine Bluff ClinicPine Bluff, AR$21.70–$27.10 / hourCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/)and search the "Find Jobs" report. Collects patient/family data to facilitate the identification of clinical, educational, psychosocial, and cultural needs and communicate data and observations to health team members.
Hospice Nurse Practitioner Gentiva Health Services Inc (Inactive)Hospice Nurse PractitionerTexarkana, ARComplete all visit types for patients on services, including Medicare-required hospice Face-to-Face (F2F) visits within CMS established regulatory timeframes, History & Physical/Initial Comprehensive visits, Problem-focused Symptom Management visits, Admission visits, Goals of Care discussions, and routine follow up visits. The Nurse Practitioner will deliver advanced clinical care, perform patient management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with physicians and interdisciplinary teams to ensure high-quality, compliant, and compassionate care.
RN House Supervisor PRN Community Health Systems IncRN House Supervisor PRNSpringdale, ARThe Supervisor, House - RN provides critical leadership during assigned shifts to oversee hospital operations and ensure the delivery of safe, high-quality patient care. Provides administrative decision-making support in the absence of department managers or senior administrators, escalating critical issues to the Administrator on Call (AOC) as needed.
Nurse Practitioner Primary Care - 30 hours (Vera - Fort Smith, AR) Vera Whole Health Provider LeasingNurse Practitioner Primary Care - 30 hours (Vera - Fort Smith, AR)Fortsmith, ArkansasThe Vera model is anchored by three core elements: high engagement, managed care, and organizational culture change, which combine to drive down utilization of costly services like ER, inpatient/outpatient visits, and transform the overall health of the organization. Provide evidence-based primary care to 10 to 15 patients per day, focusing on prevention, delivering practical treatment for chronic and acute care needs, and providing disease and case management services.
Registered Nurse (RN), Case Manager - Discharge Planner Baxter County Regional Hospital IncRegistered Nurse (RN), Case Manager - Discharge PlannerMountain Home, ARThe RN, Case Manager monitors patient progress throughout the hospitalization, modifying discharge plans as needed and continually assessing medical necessity. Ability to regularly stand and walk, occasionally bend, squat and twist, and occasionally lift up to 20 pounds using proper body mechanics.
Cardiac Telemetry Nurse CommonSpirit HealthCardiac Telemetry NurseLittle Rock, ARAs our Cardiac Telemetry Nurse at CHI St Vincent Infirmary, you'll care for patients who may have life-threatening cardiac events, post-procedural and receive patients from the Cath Lab PACU while helping their families navigate daily care and the long-term plan for healing and maintenance outside of the hospital. Administer medications, change therapeutic dressings, monitor vital signs, prep patients for procedural interventions, educate both patient and families regarding the disease process and procedural intervention, and chart with timely documentation.
Case Manager Encompass Health Rehabilitation Hospital, a partner of Washington RegionalCase ManagerFayetteville, ARFull timeJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Case Manager Encompass Health Rehabilitation Hospital of JonesboroCase ManagerJonesboro, ARJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Case Manager CHI St. Vincent Sherwood Rehabilitation Hospital, a partner of Encompass HealthCase ManagerSherwood, ARJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Case Manager PRN Conway Regional Health SystemCase Manager PRNConway, ARAn employee who is under the influence of Marijuana constitutes a threat to patients/customers which Conway Regional is responsible for in providing and supporting the delivery health care related services. Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospitals utilization review program.