Clinical consultant vs utilization review nurse

Differences between clinical consultant and utilization review nurse duties and responsibilities

Clinical consultant example responsibilities.

• Manage communications with referral source, medical providers, injure worker and other parties involve in the rehabilitation process.
• Communicate by telephone with patients and patient family members to ensure attaining appropriate resource utilization require to achieve a quality outcome.
• Conduct ACLS and BLS certification classes.
• Act as lead instructor for ACLS, arrythmia monitoring and critical care course.
• Appropriate level of care in ICU.
• Implement and instruct all staff to successfully use and operate EMR computer system.
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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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