Assistant nurse manager vs utilization review nurse

Differences between assistant nurse manager and utilization review nurse duties and responsibilities

Assistant nurse manager example responsibilities.

• Demonstrate clinical competency and compassion in providing care, using technology, administering medications, performing procedures and managing emergencies.
• Prepare for HIPAA, CMS, UNOS and JCAHO reviews, ensuring require elements of compliance and documentation of such.
• Nurse executive position reporting to the CNO.
• Network point of contact for staff/employee influenza immunization measures.
• Facilitate staff compliance with regulatory and professional standard of care (JC, CMS).
• Coordinate efforts of all aspects of the rehabilitation team to help assure the patient outcomes are as expected.
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Utilization review nurse example responsibilities.

• Monitor patients' status during surgery (circulate in operating room) and manage patients in PACU.
• Case management for acute patients refer to LTC
• Advise insurance carriers on recommend reimbursement for charges following automate bill audit utilizing ICD-9 and CPT codes.
• Provide caregiver oversight relate to care, medication administration and emergency situations.
• Identify inappropriate utilization of services/settings through the application of establish clinical criteria using InterQual and CMS guidelines for medical necessity.
• Direct contact with IPA providers.
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