This Registered Nurse is responsible to coordinate interdisciplinary professional care of a select patient population as determined by individualized plan of care, clinical pathways, managed care guidelines and contracts.
Conduct timely clinical reviews drawing upon appropriate resources and apply nationally recognized criteria to support medical necessity of patient observation admission or inpatient admission and continued hospitalization.
The Case Manager II will provide case management services to patients and their families or caregivers. Assist with assessment, participate in planning and implementation of intervention and ensure follow-up and coordination of services.
Identifies, facilitates, and advocates appropriate organizational and community resources to meet the plan of care and ensures that they are implemented for in a cost effective, efficient, and timely manner.
This Registered Nurse is responsible to coordinate interdisciplinary professional care of a select patient population as determined by individualized plan of care, clinical pathways, managed care guidelines and contracts. Mobilizes resources and manages the systems to respond to concurrent and respective data analysis, identifying variances.
The Overseas Case Processing Manager ensures staff is cross-trained to avoid processing backlogs during peak times. Creating a collaborative environment that integrates internal and external stakeholders will be crucial to the applicants success.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The Nurse Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health care needs through communication and available resources to promote optimal, cost-effective outcomes.
Promotes self-awareness and knowledge of current medical and case management standards in the community, recent innovations in patient care, and availability of alternative community, local, state, and federal resources.