Responsible for coordinating the Utilization management activities for Behavioral Services in order to assure the ongoing, comprehensive monitoring and evaluation of patient care through concurrent and retrospective review to assure appropriate reimbursement.
*Implements case management theory and practice to ensure cost-effective quality patient care and maximize reimbursement
*Educates staff and other healthcare professionals regarding effective hospital resource use and other options available
*Facilitates flow of information between physicians and peers related to certification requirements and reimbursement systems
*Demonstrates ability to provide care or service, adjusting approaches to reflect developmental level and cultural differences of population served
BS in Nursing or an Associates Degree with directly related experience totaling 4 years
MN RN licensure
3-5 years clinical experience
Basic Life Support for Healthcare Providers certification
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, ...Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.