Concurrent Review

Essential Functions:

• Authorize patient stays
• Submit insurance PA for hospital admission insurance.
• Continued stay submissions
• Discharge submission to insurance
• Appeals and Peer to Peer submission
• InterQual submission for medical necessity.
• Discharge planning for BHU and Acute Care.
• Conduct UR Committee.
• CDI Management 
• Swing Bed intake process
• All other duties within the scope of practice. 

Working Conditions:

• Possible exposure to inside environmental conditions.
• Exposure to distressed patients, families or visitors.

Physical Demands:

• Requires standing, sitting or walking for up to 8 hours or longer per day.
• The ability to lift up to 50 lbs.

Qualifications:  

• Graduate of an Accredited School of Practical Nursing or Registered Nursing or Graduate of an approved program in Respiratory Care or BSW/MSW from accredited school of social work required or similar education and experience; Missouri Licensure preferred