The Case Manager directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department.
Requirements
- Evaluation and Analysis: Contributes to cost effectiveness/efficiency and demonstrates awareness of benefit system and cost benefit analysis.
- Partnership and Collaboration: Performs effective utilization review techniques to work with physicians, third party payors, and federal and local agencies to prevent denials of payment or days.
- Quality: Evaluates the quality of necessary medical services, utilizes criteria to determine medical necessity of admission and interacts with physicians to facilitate patient assignment to appropriate alternative of care.
Benefits
- Medical, Dental, Vision, Life Insurance, Disability Insurance, and 403(b) retirement savings plan
- Paid Time Off (PTO) and holidays
- Flexible scheduling