Case Management Utilization Review Skills Checklist

  • Home
  • Case Management Utilization Review Skills Checklist

Case Management Utilization Review Skills Checklist

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

SETTING

No Experience Need Traning Able to perform with Supervision Able to perform Independently
Acute Care
Skilled/LTAC
MDS Coordinator
Home Health
Telephonic
Workers Compensation
Insurance
Managed Care
Acute Rehab
CM/UR SOFTWARE

No Experience Need Traning Able to perform with Supervision Able to perform Independently
Interqual
Milliman
MIDAS
Allscripts UR
Word Processing Software
Other: Specify

Other: Specify

REGULATORY

No Experience Need Traning Able to perform with Supervision Able to perform Independently
CMS/Medicare
HEDIS Measures
Core Measures
Medicaid/Medical
DRG
ICD 9 Coding
ICD 10 Coding
Medicaid/Medical
PROCESSES

No Experience Need Traning Able to perform with Supervision Able to perform Independently
Benefits Eligibility
Pre-Certification Review
Review for Admission Criteria
Identify Appropriate Level of Care
Review Status During Stay
Discharge Planning
Physician Advisor
Clinical Documentation Improvement
Needs Assessment/Order DME
Needs Assessment/Home Health
Needs Assessment/Hospice
Needs Assessment/Skilled
Third Party Authorization Process
Concurrent Review
Retrospective Review
PROFESSIONAL KNOWLEDGE AND SKILLS

No Experience Need Traning Able to perform with Supervision Able to perform Independently
National Patient Safety Goals
Age Specific/Population Based Care
Age Specific Competencies

No Experience Need Traning Able to perform with Supervision Able to perform Independently
Infant (Birth – 1 year)
Preschooler (ages 2-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adults (ages 22-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65-79 years)
Elderly (ages 80+ years)
EMR

No Experience Need Traning Able to perform with Supervision Able to perform Independetly
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion
CERTIFICATIONS

Expiry Date :
BLS
Certified Case Manager (CCM)
Accredited Case Manager (ACM)
Certified Disability Management Specialist (CDMS)
Certified Clinical Documentation Specialist (CDMS)
ACLS
Other: Please note any ICD 10 training
Other: Specify

I hereby certify that ALL information I have provided on this skills checklist, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.