Conduct daily admission screenings and timely initial assessments.
Validate payer and demographic details; ensure correct level-of-care determinations.
Perform utilization reviews, respond to payer requests, and manage HINN notices or appeals when needed.
Develop and update care plans; identify barriers and coordinate necessary referrals.
Collaborate with providers to support care needs, discharge planning, and covered services.
Maintain accurate, compliant documentation to support reimbursement.
Participate in interdisciplinary rounds, care conferences, and quality improvement efforts.
Follow all policies, regulatory requirements, safety protocols, and infection control standards.
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Qualifications
At least 3 years of recent acute care experience; strong case management or broad clinical background preferred.
Knowledge of InterQual or similar clinical criteria sets.
Recent experience with discharge planning and utilization review.
Active MA RN license required; BSN and CCM/CPUM certification preferred.
Excellent communication, assessment, and organizational skills.
Proficiency with EMR systems; able to work both independently and collaboratively.
For more details contact at pmohanty@navitashealth.com or Call / Text at
516-806-4227
.
About
Navitas Healthcare, LLC
certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.
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