Apr 21, 2025
General Summary of Position Assures effective use of Healthcare Organization Resources by studying insurance, governmental, and accrediting agency standards regarding patient admission, treatment, and length of stay; reviewing admitting diagnoses, medical necessity, and treatment plans; conducting face-to-face assessments; recommending appropriate levels of care; comparing patient records to established criteria; evaluating legitimacy of treatment and length of stay; maintaining utilization plans.
Key Responsibilities Determines healthcare organization utilization standards by studying insurance, governmental, and accrediting agency standards regarding patient admission, treatment, and length of stay; recommending organization standards. Guides healthcare organization utilization actions by researching, developing, writing, and updating utilization review policies, procedures, methods, and guidelines; recommending changes. Approves patient admissions...
MEDSTAR HEALTH
Clinton, MD, USA
Full time