Evaluates insurance coverage while managing the utilization review
process from admission to discharge. Completes and updates medical
records pertaining to case management and authorizations. This
participates in a multidisciplinary palliative care team.
- Joins with treatment team in reviewing comprehensive patient/
family treatment plan.
- Collaborates with physicians and other health care professional
regarding patient plan of care and intermediate care goals within
proposed time line.
- Reviews and evaluates discharge planning on all clients while
scheduling follow-up appointments.
- Evaluates insurance coverage for optimal use of benefits while
managing the utilization process from admission to discharge.
- Interviews patient / family members, obtain a complete initial
social history including financial information, and communicate
with external case managers to receive authorization of
- Performs all other duties according to entity
policies/procedures as assigned.
- Associate Degree or Diploma School Program
- Required -State of Missouri Nursing License; Preferred BSN and
UR, QA, or CM certification
- 1 to 3 years of experience
Employees in this position are, or can be, required to possess the
following physical capabilities:
SSM Health DePaul Hospital St. Louis
- Lifting, carrying, pushing and/or pulling up to 50
- Stooping, kneeling and/or crouching daily
- Standing or walking more than 6 hours a day
- Running to respond to patient emergencies
- Reaching, grasping, fingering, and/or feeling more than 6 hours
- Audio acuity in order to correctly distinguish various body
sounds (i.e., respirations, heart tones, bowel sounds).
- Audio acuity to discern sounds made by various types of
machinery or equipment that would indicate dangerous or improper
SSM Health DePaul Hospital is a 476-bed hospital offering
comprehensive medical services, including inpatient and outpatient
surgeries using state-of-the-art technology and facilities. Opened
in 1828, DePaul Hospital - St. Louis was the first hospital west of
the Mississippi River and remains the oldest continuously existing
business in St. Louis. DePaul Hospital serves patients from across
the St. Louis metropolitan area, including the communities of
Bridgeton, Florissant, Hazelwood, St. Ann, St. John, Maryland
Heights and Overland.
Our robust employee benefits package includes health benefits,
life and accidental death and dismemberment insurance, long-term
disability coverage, health and dependent care reimbursement
accounts, paid time off, tuition reimbursement, adoption
reimbursement, an employee assistance program, retirement plan
options and more.
Note: not all benefits apply to all openings.
Associated topics: domiciliary, hospice, intensive care unit, mhb,
psychiatric, registed, registered nurse, staff nurse, surgery,