Utilization review nurse vs field nurse

Differences between utilization review nurse and field nurse 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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Field nurse example responsibilities.

• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Screen prospective clients for need immunizations, implementing after evaluating patients' medical history and obtaining sign release.
• Promote health literacy by educating patients and caregivers on disease management, diagnosis, medical interventions, and pharmaceuticals.
• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Prepare and give injections and enemas, monitor catheters, apply dressings, treat bedsores and give alcohol rubs and massages.
• Document patient care in a manner that complies with JCAHO standards.
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