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|Facility:||Aspirus Wausau Hospital|
|Department:||Aspirus Wausau Hospital - Care Coordination|
Bachelor of Science
Monitors, evaluates and assists in the maintenance and improvement of efficient utilization of hospital resources through performance of pre-admission/admission and continued stay medical record reviews. Intervenes to reduce and eliminate service delays and non-acute hospital days. Monitors the quality of documentation and services provided and makes recommendations for improvement. Review determinations include, but are not limited to: Compliance with regulatory, state and federal requirements. Medical necessity and appropriateness with use of medical ISD-A criteria. Services to be rendered are timely and performed in the most appropriate setting. Maximal benefit coverage via compliance with certification required. Managed care contract requirements. Knowledge of utilization review standards and patient care practices normally acquired through graduation of an accredited school of professional nursing, a minimum of two years of acute care hospital experience, and a current
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