Utilization review nurse vs senior registered nurse

Differences between utilization review nurse and senior registered 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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Senior registered nurse example responsibilities.

• Code team member, triage, manage a team of 5 patients and 3 providers.
• Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
• Care for critically ill patients in the ICU.
• Provide triage, referrals, direct nursing care, and medication administration to incarcerate population.
• Elbow support for new Cerner EMR system.
• Implement and coordinate unit education programs covering CPR and newborn care.
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