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The Choice for Medical Excellence
Case Manager – Utilization Management
Location
South Carolina
Posted
16 days ago
Salary
0
Seniority
Mid Level
Job Description
Case Manager – Utilization Management
McLeod Health
• Oversee the process of care delivered to patients. • Coordinate/facilitate patient care progression throughout the continuum of care. • Assure the plan of care and services provided are patient focused, high quality, efficient and cost effective. • Meet directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with the physician. • Monitor length of stay and ancillary resource use on an ongoing basis and take actions to achieve continuous improvement in both areas. • Communicate information to the Utilization Management or Case Management team to aid in appropriate level of care determination and reimbursement by third party payors. • Monitor patient flow through multidisciplinary rounds and aid in implementation of processes for improvement to decrease delays. • Serve as patient advocate to ED population by identifying needs, coordinating services and resources for the management of complex patients to facilitate quality care and cost efficient outcomes. • Ensure that all elements critical to the plan of care have been communicated to the patient/family as well as members of the healthcare team.
Job Requirements
- 1-2 years of recent acute care hospital experience required.
- Data entry/computer experience required.
- Licenses and Certifications: Registered Nurse
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