Job Specification
ASSISTANT HOSPITAL UTILIZATION REVIEW COORDINATOR
DEFINITION
Under direction of the Hospital Utilization Review Coordinator,
assists in the utilization review and evaluation of patients to
ensure high quality patient care and to promote optimum use of
hospital beds, facilities, and programs, and coordinates
discharge planning; does other related duties as required.
NOTE: The examples of work for this title are for illustrative
purposes only. A particular position using this title may not
perform all duties listed in this job specification. Conversely,
all duties performed on the job may not be listed.
EXAMPLES OF WORK:
On admission may interview patients, and review patient charts
for appropriateness and classification.
Establishes lengths of stay in accord with hospital criteria.
May maintain a time schedule for recertification of patients.
Interviews inpatients in conjunction with medical staff and
nursing staff, and collects and records all information needed to
recertify extended stay at proper level of care.
Reviews cases where the necessity of extended stay is questioned,
and reports on findings.
In conjunction with medical records, may compile and maintain
statistical data on patient stay and care to improve, revise, and
update hospital criteria.
Checks patient data on utilization review form for completeness
and conformity to specific criteria.
Reviews patient charts for completion and to ensure follow-up as
prescribed by doctor.
Brings to the attention of the Hospital Utilization Review
Coordinator any irregularities in patient care.
Ensures completion of certification and recertification forms to
third party intermediary.
May attend utilization review committee and administrative
meetings in the absence of the Hospital Utilization Review
Coordinator.
Maintains liaison with the nursing division, social service
division, medical records, hospital administration, and inservice
education division to ensure continuity of patient care and
effective patient communication.
May coordinate discharge planning to effect a smooth patient
discharge or transfer either to another facility or to a home
care program.
May prepare and disseminate reports, medical care evaluation
studies, and other related functions.
Will be required to learn to utilize various types of electronic
and/or manual recording and information systems used by the
agency, office, or related units.
REQUIREMENTS:
LICENSE:
Current and valid registration as a Professional Nurse in
the State of New Jersey.
Appointees will be required to possess a driver=s license
valid in New Jersey only if the operation of a vehicle, rather
than employee mobility, is necessary to perform essential duties
of the position.
EXPERIENCE:
Two (2) years of professional experience as a general duty
nurse.
KNOWLEDGE AND ABILITIES:
Knowledge of objectives, principles, and methods of professional
nursing.
Knowledge of Medicare and Medicaid regulations and requirements.
Knowledge of hospital and institutional organization and
administration, and the laws applicable to hospital operations.
Knowledge of administrative problems involved in meeting
government requirements for patient care, optimum use of hospital
beds, and discharge planning.
Knowledge of how to conduct surveys, compile statistical
information, and prepare reports.
Knowledge of the preparation and maintenance of accurate medical
and other records.
Ability to organize assigned work and develop effective work
methods.
Ability to interpret rules and regulations of different
government agencies.
Ability to give assignments and instructions.
Ability to work effectively and harmoniously with department
heads, professional staff, associates, and representatives of
other agencies.
Ability to assist in conducting surveys, compiling statistical
information, and preparing reports containing findings,
conclusions, and recommendations.
Ability to speak and write effectively.
Ability to maintain essential records and files.
Ability to learn to utilize various types of electronic and/or
manual recording and information systems used by the agency,
office, or related units.
Ability to read, write, speak, understand, or communicate in
English sufficiently to perform the duties of this position.
American Sign Language or Braille may also be considered as
acceptable forms of communication.
Persons with mental or physical disabilities are eligible as
long as they can perform the essential functions of the job after
reasonable accommodation is made to their known limitations. If
the accommodation cannot be made because it would cause the
employer undue hardship, such persons may not be eligible.
This job specification is applicable to the following title code: | | Job
Spec
Code | Variant | State,
Local or
Common | Class of
Service | Work
Week | State
Class
Code | Local
Class
Code | Salary
Range | Note | | 00573 | | L | C | | N/A | 24 | | - |
This job specification is for local government use only.
Salary range is only applicable to state government.
Local salaries are established by individual local jurisdictions.
7/23/1997 |
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