Years of Experience: 2 year(s)
Charting System: Epic
Certifications: M SW, State licensed
Shift: Day 5x8-Hour (08:00 - 16:30)
Job Duration : 13
Skills:
Case Management/Utilization Review
Admission Criteria
Appeals and Denials
Care coordination
Concurrent Review
Continued Stay Reviews
Determine Medical Necessity per Evidence-Based Guidelines
Discharge Planning
Retrospective Review
Utilize InterQual Criteria
Utilize Milliman Guidelines
Acute Hospital
Emergency Department*
ICU*
L&D / Mother-Baby*
Medical Surgical unit
NICU*
Knowledge of Community programs (income/insurance)
Medicaid
Medicare
Additional Skills
See Text Box for additional requirements