Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and appropriate measurement tools, such as nH Predict, nH Outcome, InterQual and CMS criteria, upon admission to SNF and periodically through the patient stays Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families Complete all SNF concurrent reviews, updating authorizations on a timely basis Collaborate effectively with the patients’ health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc. Assure patients’ progress toward discharge goals and assist in resolving barriers Participate weekly in SNF Rounds providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed Attend patient/family care conferences Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the nH Outcome When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate Coordinate peer to peer reviews with naviHealth Medical Directors Support new delegated contract start-up to ensure experienced staff work with new contract Manage assigned caseload in an efficiently and effectively utilizing time management skills Enter timely and accurate documentation into the CM Tool application Daily review of census and identification of barriers to managing independent workload and ability to assist others Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement Adhere to organizational and departmental policies and procedures Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws Perform other duties and responsibilities as required, assigned, or requested