Assume primary responsibility of cases for documentation of appropriate medical necessity for the inpatient and/or observation status in the ER setting. Communications with physician, ancillary staff, and payers and assists in arranging transfers or alternate placement when indicated. Assures proper level of care assignment. Facilites with Case Managers and other allied health professionals to promote and ensure that quality care is provided and outcomes are achieved in a timely and cost effective manner. Supports hospital goals and objectives in compliance with regulatory guidelines. Works in collaboration with all healthcare disciplines to assure a continuum of appropriate and timely services. Assess apropriateness, quality, and cost effectiveness of proposed hospital, medical and corporate goals and objectives.Qualifications
Case Manager must be a graduate of an accredited school of Nursing, Health Information Management, or Social Work, RN preferred. Prefer a minimum of four years experience in hospital setting. One-year experience in utilization management/case management is preferred. Must have skills in effective communication and critical thinking, ability to establish priorities, and creative problem solving. Must be able to work independently. License, if applicable, must be kept current.
Glenwood is an equal employment opportunity employer. Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex, national origin, age, disability or any characteristic protected by law.