Case Management, Certified Case Manager (CCM), Clinical Medicine, Computer Skills, Discharge Plans, Government Regulations, Hospital, Interpersonal Skills, Needs Assessment, Nursing, Problem Solving Skills, Registered Nurse (RN), Resource Utilization, Service Delivery, Utilization Management
Overview
Description
Job Summary
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities
Utilization Review
Discharge planning
Readmission Reduction Participation
Payer Communication and denial reduction
Completes assigned goals.
Specifications
Experience
Minimum Required
Preferred/Desired
Education
Minimum Required
Preferred/Desired
Training
Minimum Required
Preferred/Desired
Special Skills
Minimum Required
Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Preferred/Desired
Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Licensure
Minimum Required
Preferred/Desired
B
Baptist Memorial Health Care