Linda Rich

Reviewed for medical necessity, outpatient procedures, durable medical equipment. Applied health plan, state and federal, guidelines. Did detailed review of charts to know patient needs and health status.

Educated patients when needed to direct care.

Worked with medical directors and professional staff to maintain proper care.

Worked call for after hour admits and weekend admits. Getting from hospital case manager detailed report on patient medical status at time of admission.

Reviewed inpatient hospitalizations, to determine care, needs and discharge needs.

Documenting all care, decisions, and medical needs, following mandated guidelines

Was responsible for utilization review of medical group, which included all outpatient procedures, home health, hospice, durable medical equipment, inpatient admissions and review. Position started out for Scripps Memorial and Scripps Green, Clinic. Would make inpatient rounds with physician. Was responsible for presenting difficult cases to physician review boarded once weeK