Utilization review nurse vs occupational health nurse

Differences between utilization review nurse and occupational health 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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Occupational health nurse example responsibilities.

• Participate in manage care activities to produce health change, specifically providing diabetes education and lifestyle counseling in chronic disease areas.
• Facilitate rehabilitation of injure employees, utilizing case management to ensure coordination of care, FMLA and return-to-work program.
• Provide emergency triage care as appropriate, dispense medications and treatments, and assist physicians with physical exams and/or psychiatric evaluations.
• Exercise compassion and respect for all cultures.
• Prepare for HIPAA and MI-OSHA reviews and audits.
• Maintain and coordinate a and written a program.
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