ED RN Access Case Manager, Utilization Management, Full time, 12pm - 12:30 am
The RN ED Access Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians, and other key disciplines in order to coordinate admissions, transfers and repatriation to PIH Health Hospitals through the emergency room or direct admission. The RN ED Access Case Manager works closely with insurance and various payor to coordinate and assist with repatriation/transfer of out-of-network patients from PIH Health Hospitals to the patient’s contracted facility. The RN ED Access Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve authorization and reimbursement for services for the appropriate le
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