Requirements:

NJ RN License

Case Management Experience - minimum 1 year

Psychiatric Hosipital Experience - minimum 1 year

100% In-Person Position

Function: To ensure appropriate utilization of facility resources relating to the medical necessity of admissions and continued stays, levels of care, and length of stay for hospitalized patients.

Duties and Responsibilities:

1. Perform admission reviews after patient is admitted confirming medical necessity for admission.

2. Perform concurrent reviews, as scheduled, on hospitalized patients to assure continued medical necessity for stay.

3. Generate weekly Medicare census reports.

4. Evaluate and report on length of stay for hospitalized patients via the monthly UR committee meeting report.

5. Communicate with the attending clinician on the reason for continued stay for Medicare and insurance patients.

6. Report on status of Medicare and insurance patients at the weekly UR meeting.

7. Track the completion and signage of Medicare 1M letters on admission and discharge.

8. Manage Medicare certification/recertification form to assure timely completion by the attending physician.

9. Review of medical records to ensure the appropriate and necessary documentation to maintain medical necessity is found in the medical record.

10. Provide education on documentation required for medical necessity as applicable.

11. Follow up with the Social Work department as necessary regarding essential communication of Medicare and insurance patients.

12. Provide case management of insurance payors by obtaining and providing information to the insurances for continued stay authorization.

13. Communicate to all involved disciplines regarding continued insurance authorizations.

14. Collection, input, and submission of the HIBiPs information quarterly.

15. Other responsibilities as assigned.

Job Type: Full-time

Pay: $38.00 - $42.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Medical specialties:

• Psychiatry

Physical setting:

• Hospital
• Inpatient
• Office

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Blackwood, NJ 08012: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Utilization review: 1 year (Required)
• Psychiatric care: 1 year (Required)

License/Certification:

• RN License (Required)

Work Location: One location

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