Utilization review nurse vs nurse coordinator

Differences between utilization review nurse and nurse coordinator 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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Nurse coordinator example responsibilities.

• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Assume administrative oversight of medical, pediatric and chemical dependency rehabilitation units during leaves of absence or vacancy.
• Communicate with patients regarding test results and plan after participating in review of diagnostic testing results with attending physician.
• Organize and schedule patients for multiple testing procedures and responsible for extensive patient teaching regarding all aspects of fertility and infertility.
• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Contribute to the telemetry and radiology departments
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