Utilization Management Nurse
2 weeks ago
About Integrated Home Care Services:
Integrated Home Care Services (IHCS) is dedicated to providing a comprehensive delivery system within the comfort of patients' homes. Our offerings encompass Durable Medical Equipment (DME), Respiratory Care, Home Health, and Home Infusion services. We collaborate with a select network of Medicare and/or Medicaid Certified and Accredited providers to meet the needs of our patients around the clock. Our primary goal is to deliver the highest quality in-home care services, ensuring our patients' well-being is our top priority.
With over three decades of experience, IHCS stands as a trusted leader in the Home Health sector, Durable Medical Equipment, and Home Infusion Services. If you possess a passion for motivating and guiding teams, this role may align with your career aspirations.
Key Responsibilities:
As a Utilization Management Nurse, your role will be pivotal in ensuring that home health care services are delivered with optimal quality, cost-effectiveness, and compliance. You will conduct continuous reviews and audits of patient treatment files to prevent unnecessary procedures, ineffective treatments, or overly extensive home healthcare services.
- Perform concurrent reviews of patients' clinical data for efficiency.
- Review precertification requests for medical necessity on an ongoing basis.
- Coordinate patient care requirements with a multidisciplinary healthcare team.
- Maintain precise records of all patient-related interactions.
- Exhibit strong organizational skills and effective interpersonal communication.
- Provide updates to the Manager of Utilization Management for evaluation.
- Current state licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN).
- A minimum of two years of experience in Utilization Management.
- Proficient in word processing and spreadsheet software.
- Certification in Utilization Management or Case Management is preferred.
At IHCS, we are committed to excellence through collaboration, where our patients' needs are paramount. We celebrate diversity and are dedicated to fostering an inclusive environment for all employees.
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