Clinical Resource Utilization Specialist
1 week ago
Job Summary:
The Clinical Resource Utilization Specialist is responsible for ensuring the appropriate use of healthcare resources while maintaining high-quality patient care. This role requires a strong understanding of clinical guidelines, regulatory requirements, and healthcare policies.
Key Responsibilities:
- Conduct thorough reviews of patient information to determine medical necessity and appropriateness of care.
- Utilize clinical judgment and expertise to make informed decisions regarding resource utilization.
- Collaborate with healthcare teams to ensure seamless coordination of care and optimal resource allocation.
- Stay up-to-date with the latest clinical guidelines, regulatory changes, and healthcare policies to ensure compliance and best practices.
- Communicate effectively with patients, families, and healthcare professionals to ensure understanding and cooperation.
- Participate in quality improvement initiatives to enhance patient outcomes and resource utilization.
Requirements:
- Graduate of an accredited School of Nursing.
- Two or more years of clinical experience with at least one year in the acute care setting.
- RN License in state of employment or compact required.
- Certification in Case Management preferred.
Work Schedule:
8AM - 5PM Monday-Friday
Work Type:
Full Time
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