Utilization review nurse vs head nurse

Differences between utilization review nurse and head 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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Head nurse example responsibilities.

• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Receive intensive training for critical care skill development upon transferring to the medical ICU.
• Perform advanced nursing care to acute/chronic medical/surgical, cardiac, thoracic surgery, neurosurgery, orthopedic and oncology/ hematology patients.
• Certify staff in CPR and blood glucose monitoring.
• Develop and implement an intensive care class for the staff; implement ACLS class for all staff.
• Develop process improvement plan with bundles for sedation and ventilation.
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