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United States - Nationwide

Charles R. Drew University of Medicine and Science

Los Angeles, California

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Alivia Care/Community Hospice & Palliative Care

Jacksonville, Florida

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UCLA

Los Angeles, California

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CHRISTUS Health

Santa Fe, New Mexico

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Harris Health System

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AdventHealth

Tampa, Florida

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AdventHealth

Tampa, Florida

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Kindred Hospitals

Seattle, Washington

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Veterans Affairs, Veterans Health Administration

Los Angeles, California, California

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CommonSpirit Health Mountain Region

Garden City, Kansas

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Fred Hutchinson Cancer Center

Seattle, Washington

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WMCHealth

Valhalla, New York

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Surgical Validation Nurse Case Management/Full-Time
DescriptionPOSITION SUMMARY:  Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to clinical and non-clinical departments.    Documents objective findings against approved indicators.  Assists with retrospective reviews and medical necessity denials per communication with third party payors.  Follows UR policies and procedures and assists with continually improving the quality and effectiveness of the utilization management program at CSV.RN is responsible to oversee outpatien


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