The Utilization Management (UM) Case Manager as a member of the health care team, collaborates to enhance the delivery of patient care services along the continuum of care. The UM Case Manager ensures the appropriate level of care determination for each patient. This nurse helps to ensure the institutional standards of high-quality patient care, reducing cost and ensuring reimbursement. Through broad knowledge of clinical care and systems management, the case manager evaluates, predicts, and facilitates the trajectory of patient care for appropriate admission classification and continued stay authorizations.
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