Teams at Community Health Systems

Performs independent diagnostic ultrasound examinations, verifies patient ID and orders, documents findings in EHR and PACS, ensures patient safety and comfort, maintains equipment and supplies, follows protocols and infection control, and holds required sonography certification and BCLS.

Evaluate medical necessity and appropriateness of admissions and continued stays, conduct reviews using evidence-based criteria, coordinate with providers and payers for authorizations and appeals, document activity in case management/EHR, analyze utilization trends, support training, and escalate complex issues.

Manage utilization review processes including initial and continued stay reviews, payer communications, authorization tracking, denial/appeal coordination, documentation in case management systems, KPI monitoring, peer-to-peer coordination, and training/support for team members to optimize patient authorization and reduce denials.