Under minimal supervision, reviews and screens for the appropriateness of services, the utilization of hospital resources and quality of patient care rendered at Henry Ford Allegiance Health. Combines clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification and education, facilitates the quality of health care delivery in the most cost effective and efficient manner.
Required Skills, Knowledge, and Abilities:
Knowledge of the acute care provided to neonate, pediatric, adolescent, adult, and geriatric patients.
Ability to function successfully and independently in an extremely challenging environment.
Must be self-directed, flexible, committed to teamwork.
Must demonstrate initiative and willingness to learn.
Demonstrates leadership ability, communications, and interpersonal skills necessary to interact effectively with physicians, management, staff, external agencies/customers and patients/families.
Must possess analytical, data management and computer skills.
Bachelor's degree in Nursing (BSN).
Case Management certification.
Utilization management and discharge planning experience for the acute care or post- acute care setting.