Job Description
Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network , a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network . Summary Ensures appropriate use of hospital resources by reviewing all patients admitted to the hospital and evaluating appropriateness of admission using approved criteria. Ensures appropriate patient class assignment (inpatient, outpatient) to ensure compliance with third party payer requirements. Job Duties Acts as a resource and educates on the appropriate level of care assignment, patient class, and utilization management-related work. Provides timely, accurate, and thorough clinical reviews to assist in the patient class decision-making process. Develops and implements methods, policies, and procedures to improve departmental efficiency and overall effectiveness. Partners with unit-based care managers to ensure appropriate exchange of information regarding patient financial status, diagnosis, and discharge need
