Post-Acute Care Nurse
2 weeks ago
As a PAC Nurse specializing in Utilization Review, you will play a pivotal role in optimizing patient care through effective collaboration and clinical assessment.
Key Responsibilities:
- Collaborate closely with the PAC Medical Director to develop care plans and set achievable goals, ensuring thorough review of discharge plans and monitoring length of stay for optimal patient outcomes.
- Serve as a clinical resource for unlicensed Post-Acute Care Coordinators, offering guidance and clarifying directives from referral sources.
- Act as the primary liaison with assigned post-acute facilities to gather essential clinical information and proactively obtain updates on patient status.
- Work in conjunction with Supervisors and Market Engagement Directors to address facility concerns and streamline processes.
- Communicate any customer service or provider issues to your supervisor and conduct regular telephonic check-ins with facility representatives to assess each member's appropriateness for continued care.
- Authorize continued patient stays at Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH), and Home Health care, in accordance with established medical guidelines.
- Utilize clinical expertise to evaluate medical necessity for services and devices, ensuring timely case reviews and determinations in compliance with contractual and regulatory standards.
Qualifications:
- Minimum of 2 years of experience in concurrent review and discharge planning.
- At least 2 years of experience in utilization review or management.
- Possession of an active RN license, with compact or multi-state eligibility.
Job Type:
This position is a Contract-to-Hire opportunity.
Work Environment:
This role is fully remote, providing flexibility and convenience.
About Actalent:
Actalent is a leading provider of engineering and scientific services, dedicated to advancing initiatives through specialized expertise. With a vast network of consultants and clients globally, we are committed to fostering diversity, equity, and inclusion within our workforce. We value the unique contributions of every individual and strive to create an inclusive environment that promotes growth and recognition.
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