VIRTUAL UTILIZATION REVIEW

Other jobs >> General

Negotiable

Permanent

Description

VIRTUAL UTILIZATION REVIEW



Professional

Richmond, VA

Department: STEWARDSHIP CONTING-REV CYCLE

Requisition: ******BR

Schedule: PRN

Shift: Day

Hours: 8:30 AM - 5:00 PM, Some Weekends

Existing Employees Here

BON SECOURS RICHMOND REVENUE CYCLE

POSITION SUMMARY

The Virtual Utilization Review Case Manager (VUM) is a key contributor to the overall financial, quality, and clinical performance of the organization. The VUM supports an outcomes-oriented, patient care delivery system, which places the patient at the center of all activities. The Virtual Utilization Review CM facilitates the improvement of overall quality and completeness of medical record documentation. The VUM provides a positive financial impact to the institution through extensive interaction with physicians, nurses, other patient care givers, and coding professionals to ensure that medical record documentation accurately reflects the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete. Monitors and evaluates care to ensure costs are medically necessary, provided in the appropriate setting, and are generated according to governmental and regulatory agency standards.

JOB REQUIREMENTS

1. Current unrestricted license to practice nursing. Baccalaureate degree preferred.

2. Five years nursing experience in an acute care environment required. Utilization review/discharge planning experience

preferred.

3. Recent and working knowledge of medical necessity review criteria experience preferred.

4. Current working knowledge of quality improvement process preferred.

5. Certification appropriate to this job description (MCG) required within 3 years of hire.

6. Ability to receive high speed internet at home.
  • 1
  • Negotiable
  • None
  • None
  • Re-144505
  • Permanent
  • 2

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