The role involves reviewing inpatient and outpatient admission records to determine appropriate admission status at Mercy Medical Center and Mercy West Lakes
Job Summary
The role involves reviewing inpatient and outpatient admission records to determine appropriate admission status at Mercy Medical Center and Mercy West Lakes.
Candidates will collaborate with attending physicians and insurance providers to obtain authorizations and manage continued stay approvals.
The position requires applying Milliman Care Guidelines and payer-specific criteria while documenting activities in the STAR admitting system.
Matching Summary
The role involves reviewing inpatient and outpatient admission records to determine appropriate admission status at Mercy Medical Center and Mercy West Lakes.
Skills & Requirements
Must-have
Current Iowa RN license required
Five years clinical nursing experience
Knowledge of CMS rules and utilization review
Nice-to-have
BSN or healthcare-related degree preferred
Utilization Review certification within 12 months
Strong independent decision-making skills
Key Requirements
Current Iowa RN license
Minimum 5 years clinical nursing experience
Completion of Mandatory Reporter abuse training within 3 months