Compassionate and motivated Registered Nurse with extensive experience in direct patient care, case management, and utilization review. Proven ability to build strong relationships with healthcare providers through exceptional communication skills. Demonstrates a commitment to enhancing operational efficiency and quality of care delivery through effective problem-solving and time management strategies. Aiming to leverage expertise in patient care and care coordination to contribute to a dynamic healthcare team.
● Conduct all precertification for inpatient/outpatient, concurrent reviews, and retrospective for the facility.
● Promote Swingbed program and review referrals.
● Market Swingbed program to surrounding facilities and network with larger institutions.
● Coordinate weekly Multidisciplinary meetings.
● Utilize MCG and Interqual criteria for admission criteria.
● Monitor length of stay and service type of patient.
● Collaborate with Physicians, Social Workers, and Multidisciplinary teams for discharge planning.
● Make discharge follow-up phone calls.
● Review all inpatient/outpatient charts on a daily basis.
● File Appeals as necessary.
● Performed wound care consults and write plans of care for patients with acute and chronic wound issues.
● Perform referrals both inpatient and outpatient.