This position will support the Federal Government's response efforts to COVID-19.Learn more about this agency
This position is located in the Division of Quality Management, Utilization Management, Chinle, AZ. The primary purpose of this position is to serve as a Utilization Management Nurse/Compliance Officer. Incumbent will ensure the receipt of high quality, cost efficient medical outcomes for those enrollees identified as having the need for inpatient/outpatient treatment or overlong hospital stays.
- Assess, plans, monitors, and evaluates patient care through utilization review.
- Reviews and assesses inpatient and outpatient medical records.
- Reviews and analyzes treatment records to evaluate quality necessity.
- Identifies possible admission clinical discrepancies and discusses with attending physician.
- Collaborates clinically with other healthcare professionals to ensure there is a process for the collection of utilization data.
- Evaluates discharge planning and case management activities and conducts ongoing monitoring.
- Prepares reports for dissemination during Inpatient Discharge Planning, Conferences.
- Performs pre-admission, admission and continued stay review of elective, urgent, and emergency admissions.
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This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/566707700. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.