Utilization review coordinator vs case management coordinator

Differences between utilization review coordinator and case management coordinator duties and responsibilities

Utilization review coordinator example responsibilities.

• Initial triage of members, administrative intake of members and managing the admission/discharge information post-notification.
• Identify and access Medicare entitlement benefits for those patients who meet eligibility requirements both prior to admission and during concurrent review.
• Include inpatient/outpatient acute setting, SNF, DME.
• Maintain a preventative maintenance schedule on all HVAC equipment.
• Coordinate transfers to SNF, ICF, and residential care.
• Assess patient medical needs using nationally recognize criteria sets such as InterQual.
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Case management coordinator example responsibilities.

• Manage caseload by providing care coordination to individuals with a primary intellectual/developmental disability diagnosis all of whom receive community-base waiver services.
• Discharge planning including but not limit to rehabilitation, durable medical equipment and home healthcare.
• Provide counseling support to clients with mental illness, HIV/AIDS, autism, and handicaps.
• Act as medical resource for appeals function.
• Input client's information into HMIS portal database.
• Design custom reports within AVAYA CMS used to assist with forecast and staff implementation.
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