Utilization review nurse vs clinical liaison

Differences between utilization review nurse and clinical liaison duties and responsibilities

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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Clinical liaison example responsibilities.

• Manage social media outlets for the organization; such as Facebook, update weekly status and weekly inspirational videos.
• Provide crisis intervention and triage services to clients in compassionate and responsible manner, serving individually tailor services to clients.
• Perform clinical evaluations to determine if patients would qualify with acute rehab criteria and review with physicians.
• Communicate with physicians regarding prospective patients and their diagnosis, rehabilitation needs and expectations of family prior to admission.
• Spearhead marketing and business initiatives to increase patient referrals for skil nursing facility specializing in rehabilitation services for senior adults.
• Provide elbow support for physicians learning to navigate Cerner and use PowerPlans.
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