Case Manager - Utilization Rvw

SUMMARY: The UR/denials nurse conducts chart reviews to ensure medical necessity, appropriateness of admission, continued length of stay and level of care using clinical information and clinical criteria. The role also participates in the denial management process as well.

EXPERIENCE: Minimum 2-3years experience in Case Management or related healthcare field

SPECIAL SKILLS: Computer Proficiency

OTHER: Excellent communication, interpersonal, organizational and presentation skills

LICENSE/CERT: Required: RN (Registered Nurse) State of Missouri Preferred: CCM (Certified Case Management)

EDUCATION: Required: Bachelors - Nursing