Case Manager PRN

About This Role

This Case Manager coordinates the care and service of selected patient populations across the continuum of care. The role promotes effective utilization of healthcare resources and collaborates with an interdisciplinary team to achieve optimal clinical and resource outcomes.

Responsibilities

• Coordinate care and services for selected patient populations across the continuum of care
• Promote effective utilization and monitoring of health care resources
• Maintain accurate knowledge base of payer information for team collaboration
• Assume a leadership role with the interdisciplinary team to achieve optimal clinical and resource outcomes
• Represent the department in meetings with senior administration
• Provide enhanced expert services to all departments within the organization
• Demonstrate ongoing leadership within the hospital, community, and professional organizations as required
• Discharge planning for inpatients
• Utilization Review for inpatients

Requirements

• BSN
• Minimum 5 years of related experience in healthcare
• Recent case manager experience
• Demonstrated experience in oncology nursing, utilization review, quality management, and/or case management
• Computer literate
• Knowledge of cost accounting and financial data analysis
• Knowledge of Medicare and Medicaid regulations
• Knowledge of third party reimbursement
• Knowledge of medical record coding and pricing of services

Qualifications

• BSN
• Minimum 5 years of related experience in healthcare; recent case manager experience