Utilization Manager
CurrentValidates authorization for all bedded patients. - Validates commercial payer authorization within the contractual timeframe at time of presentation, every third day or as needed ( e.g. ED, Direct Admit, Transfers). - Manage concurrent cases to resolution care that may impact payer approval to authorize care as medically necessary - Partner with Revenue Cycle team to support resolution of retrospective denials. - Coordination of review with third party reviewers. - Manage retrospective review process. - Conducts initial review and continued stay reviews as designated in UM plan. -