Case Manager - RN PRN Premium

The Case Manager 1 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.