Incumbent collaborates with the attending and resident medical staff, as well as nursing, ancillary and technical staff to coordinate the delivery of high quality, individualized, cost-effective patient care. Coordinates resource utilization throughout the Health System and evaluates services provided. Coordinates interdisciplinary referrals utilizing pre-established criteria for quality and appropriateness to the acute care or ambulatory setting. Performs the appropriate utilization review functions on the managed population utilizing approved Intensity of Service and Severity of Illness criteria. Supports the performance improvement process through comprehensive analysis of patterns and trends. Interacts with the patient/family. Utilizes nursing process, as appropriate, to set priorities, plan, organize and implement care that is directed toward self-care outcomes.
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Job Type
Full-time
Career Level
Mid Level
Number of Employees
101-250 employees