Under general supervision, the Utilization Review Case Manager (UR CM) performs review of patient charts as defined by the Hospital's Utilization Review Plan. The UR CM validates the patient’s admission status and level of care to be at the most appropriate based on nationally accepted admission criteria. The UR CM uses medical necessity screening tools, such as MCG criteria to complete initial and continued stay reviews in determining appropriate admission and continued stay status and level of patient care. The UR CM secures authorization for the patient’s clinical services through collaboration and communication with payers as required. The UR CM follows the UR process as defined in the Utilization Review Plan in accordance with the CMS condition of Participation for Utilization Review.