- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... payer requirements. These discussions are to help the UR Clinical Specialist understand the reason for admission,...documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if… more
- Community Health Systems (Franklin, TN)
- …medical necessity, both for admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the ... admissions and extended hospital stays with portals, faxes and phone calls. The Utilization Review Clinical Specialist will monitor adherence to the… more