Job SummaryCoordinates appropriate level of care for inpatient and outpatient therapy services. Responsible for pre-certification requests, authorization and concurrent review as determined by individualized plans of care, managed care guidelines, contracts and clinical pathways. Responds to clinical, outcome system, and fiscal data. Participates in programs to improve clinical, quality and fiscal outcomes.Job DutiesReceives and responds to requests for inpatient and outpatient rehabilitative therapy services as well as for services provided in a Skilled Nursing Facility or at home through Home Health.Reviews information from providers to assure appropriate level of care and enter authorization into the appropriate Health Plan computer systems.
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