Modified 4:00:00 AM Account Manager: Haley Hindes Account Manager Email: COVID-19 Vaccine: Unknown Flu Vaccine: Unknown Job Requirements & Qualifications Previous Charge Experience : - Years of Experience : 2 Patient Ratio Experience : Charting System Experience : Required Charting System Name : Epic Community Hospital Experience : Preferred LTAC Experience : - Trauma Level I Experience : - Trauma Level II Experience : - Travel Experience Required : Yes Certifications : BLS, RN state license, ACM/CCM*Skills : Acute Hospital, Admission Criteria, Admission Criteria, Appeals and Denials*, Appeals and Denials*, Concurrent Review, Concurrent Review, Continued Stay Reviews, Continued Stay Reviews, Determine Medical Necessity per Evidence-Based Guidelines, Medical Necessity, Pre-Cert Review*, Prior Authorization, Prior Authorizations, Retrospective Review*, Retrospective Review*, Utilize InterQual Criteria, Utilize InterQual Criteria, Utilize Milliman Guidelines, Utilize Milliman Guidelines, Payor Portals* Unit Details Staffing & Scheduling Scheduling Type : - Patient Ratios Days : - Patient Ratios Nights : - Patient Ratios Weekends : - Float Required : - Call Required : - Weekend Coverage : - Number of Weekend Shifts Per Contract : - Pre-Approved Time Off : - Orientation Hours : 24 Facility & Patient Care Details Patient Age Groups : Adults, Geriatrics Daily Census : 30 Number of Visits Per Day : - Number of Rooms : - Number of Beds : - Additional Unit Information Interdisciplinary Support : - Patient Diagnoses : Utilization Review experience required. Experience with completing Utilization Review in the hospital setting and using InterQual and MCG evaluation criteria to justify admissions and level of care with insurance companiesLICENSURE /CERTIFICATIONNC or compact state RN licenseBLS RequiredACM/CCM Preferred Average daily census : 30Orientation: 24 hoursThis position facilitates utilization management processes to support the right care is provided at the right place at the right time.