Weekend Only Saturday and Sunday 8a - 8p

Summary: To perform concurrent utilization review activities of all patients within the case load. Understanding and applying Interqual criteria as well as guiding and educating the medical staff on appropriate documentation in accordance with Medicare Regulations. Education: Current and valid State of New Jersey license (or legal permission to work from the New Jersey Board of Nursing). BSN preferred. Experience: Minimum of 3 to 5 years experience in utilization management, case management, Interqual Criteria, Milliman and Robertson Criteria , Medicare/CMS guidelines. Special Skills: Registered Nurse. Licensed in State of New Jersey. Current acute care clinical knowledge with broad base medical/surgical background. Demonstrates effective interaction and communication (oral, writing, presenting) skills. Ability to perform work accurately and pay attention to details, often changing from one task to another without loss of efficiency or composure. Ability to function competently in stressful situations and a changing work environment related to changing patient needs. Ability to work cooperatively within the health-system; with patients and family members; and with multidisciplinary team members (i.e., physicians, Rehab, Respiratory, DI, Lab, etc.). Ability to utilize effective time management to set priorities, perform job related responsibilities, and respond quickly to emergency situations. Ability to use critical thinking and clinical reasoning skills effectively problem-solve and provide case management services. Supervision Expected: None Supervision Received: Supervision from the Medicare Compliance Coordinator. Working Conditions: Hospital environment. Requires walking and standing. Minimal exposure to infection, strains, blood borne pathogens, and HIV related illnesses. OSHA: Bloodborne Pathogen Category I Employees in this job description are expected to have contact with bloodborne pathogens and as such they are required to be oriented and annually trained under the Federal Occupational Safety and Health Administration''s Bloodborne Pathogen Standard (CFR 1910.1030)