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BR
Brighton Rehabilitation & Wellness Center
Director of Utilization Review
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Job Description
The Director of Utilization Review (UR) is to manage effectively and efficiently all aspects of the MDS/ Case management / Restorative/ Care planning/ 5 Star and Quality Measures while capturing clinical reimbursement. This should be done while following the RAI manual, DOH guidelines, CMS guidelines, Federal and State Guidelines and Corporate Compliance. 1) Graduate of an accredited School of Nursing with current Pennsylvania nursing license 2) Maintain CEU credits through seminars, in-service programs, and professional journals relative to professional growth 3) Strong knowledge of the RAI, MDS, state and federal guidelines, 5 star reporting and quality measures, and restorative nursing