Job Summary: Serves as a Provider consultant in the coordination of care and utilization review process to determine legitimacy of admission, treatment, and length of stay in the hospital in order to comply with governmental and commercial insurance company reimbursement policies and procedures. Leads the unit care rounds and acts as resource and guide for multi-disciplinary team with efficient and appropriate utilization of resources. Analyzes patient records against insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, patient status,
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Case Management Society of America 5034A Thoroughbred Lane Brentwood, TN 37027