• Facilitates processes to expedite patient care analyzing variations from predicted utilization.• Work with clients with Medical Assistance, Medicare and Managed Care products.• Experience in acute care, short term rehabilitation and long term care guidelines.• Knowledge of interQual, utilization review, ICD-9 codes.• Reviews medical necessity forms, Medicare certification.• Placement, transport arrangements, home care services. • Conducts assessment of patient and family needs to formulate discharge plan assuring continuity of care.• Makes referrals to local area of aging, children and youth agencies. • Facilitates process for best possible patient care in most cost- effective way.• Facilitates appropriate reimbursement through ongoing communication with insurance companies.

• Completes and audits MDS 3.0.• Monitors MDS completion by other disciplines in accordance with RAI manual regulations.• Knowledge of RUGs, PA case, Medicare, Managed care.• Prepares physician certifications.• Reviews clinical charts.• Interview patients/families to set up treatment goals.• Develop, implement and evaluate discharge plans• Make referrals to placement agencies.• Provide case management and oversight services.• Provide patient/family support post- discharge.• Participates in quality improvement.• Follows infection control procedures.• Ensures HIPAA compliance.