This position involves 60% utilization review coordination to ensure accurate Medicare data collection and compliance, 30% case management duties like coordinating patient services and discharge planning, and 10% work in health information management. As a case manager, the role facilitates communication among the care team and acts as a liaison between patients, families and payers. Applicants must be a licensed registered nurse and preferrably certified in functional independence measurement.

1. UTILIZATION REVIEW NURSE
This position will be working: 60% UR/PPS Coordinator, 30% Case Management, 10% HIMS.
Utilization Review (UR) Duties (60%):
Using discretion and independent judgment, the UR/PPS Coordinator coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective
Payment System for Medicare patients. The UR/PPS Coordinator oversees all aspects of data collection on the patient assessment instrument, ensures the presence of supporting
documentation, and provides staff education to ensure compliance with Medicare guidelines. In addition, the UR/PPS Coordinator develops and interprets policies and procedures and acts
as the primary resource for immediate problem solving in regards to functional independence scoring. This position requires a positive working relationship as well as serving as an
educator to the medical and rehabilitation staff.
Case Manager Duties (30%)
The Case Manager serves as the interdisciplinary team leader to provide management of a patient's hospitalization from admission to post discharge and is an effective communicator and
manager of information in coordinating health care decisions. Primarily, the Case Manager oversees the effective coordination of services in the areas of: insurance relations, fiscal
management, admission and discharge coordination, case conferencing and communication relative to the overall treatment plan. As the interdisciplinary team coordinator, the case
manager facilitates communication amongst the team members regarding delivery of services to patients and families, performs ongoing utilization review, acts as a liaison to the payor,
assures that cost effective treatment is provided by the team, facilitates timely communication regarding the patient's care, establishes and implements the discharge plan. The case
manager assures that regulations regarding patient's rights are fulfilled, and addresses the patient's psychosocial status and support systems issues. The Case Manager may work in either
the inpatient or outpatient setting.
POSITION REQUIREMENTS AND ESSENTIAL JOB FUNCTIONS Education, Training and Years of Experience:
License or Certification: - Appropriate to licensure , i.e., bachelors, associates degree or allied health degree as required
- Licensed registered nurse is required for licensure
- FIM certified is preferred (will train)
Physical Requirements:
- Good visual acuity and ability to communicate.
- Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds.
Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements.
Proficiency or Productivity Standards:
- Meets established attendance standards.
- Adheres to hospital/department dress code including wearing ID badge.
- May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines.
- May be required to work on religious and/or legal holidays on scheduled days/shifts.
- Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster.
- May be required to stay after workday to assist after a disaster situation until relief arrives.
- May be required to perform other duties as assigned by supervisor.
About Our Facility
We are a 41-bed free-standing hospital designed to provide comprehensive rehabilitation for people who are medically and physically disabled. Our mission is to guide patients with
physically disabling conditions along a comprehensive and individualized treatment pathway so they can reach the highest level of physical, social, and emotional well-being. We offer a
wide range of specialized medical and therapeutic services for: Stroke, Brain Injury, Parkinson’s, Multiple Sclerosis, Orthopedic, Vital Stem Therapy, Peds SLP, & Bioness delivered by exp'd
professionals.
Equal Employment Opportunity: We are an Equal Opportunity Employer.
About US
We are one of the nation's largest providers of rehabilitative healthcare services. We place a priority on clinical excellence, responsiveness to individual patient needs, highly specialized
treatment programs and innovative thinking that leads to increasingly positive outcomes and opportunities - for patients and staff.
To achieve these standards, we actively seek the best professionals in the business. Our employees are critical to our success.
How to Apply: Please obtain a referral card from YPIC at the CRC Center and information on how to apply will then be provided. Contact YPIC at the
address and numbers below:
3826 W. 16th Street • 928-329-0990 • Fax: 928-782-9558TTY (928) 329-6466 • www.ypic.com

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