Must have the ability to prepare and submit on behalf of the hospital such reports as may be required and beneficial in response to payer denials relating to medical necessity, appropriateness of care, etc.
Develop and implement individualized plan of care. Educates patients and their families about the disease, modes of transmission, universal precautions, and medication adherence. Provide counseling as needed.
Responsible for facilitating and coordinating the care delivered to an assigned group of patients through multidisciplinary and patient/family collaboration to ensure quality and cost effective outcomes are delivered within appropriate length of stay parameters.
As the Intensive Supervision Case Manager, you will use your background in criminal justice and case management to develop, implement, and coordinate case management and individual service plans for ISAP Program Participants in conformance with state and federal regulations as well as program requirements.
In this role, you will manage complex cases and serve as a strong and knowledgeable liaison between acute care and critical care teams, coordinating the efforts of social workers, feeding specialists, PTs, OTs, cardiologists, intensivists and neonatologists all in support of patients and their families.
Communication with claimants, medical professionals, claims staff and others to obtain information necessary to make sound medical decisions. In addition, responds to various written, telephone and/or in-person inquiries regarding status of case.
The RN Case Management utilizes their skills to collaborative assess, plan, facilitate care coordination, and advocate for options and services to meet an individuals and familys comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.
Responsible for performing direct clinical and administrative support for an adolescent residential service program, including clinical case management, advocacy, education, and trauma informed services.
In this role, you will provide case management to members who are identified (specifically members being discharged from hospital admissions) in accordance with companies Medical Management policies and procedures.
This individual is responsible for the medical case management of work related injuries which includes assessment, planning, coordination, implementation and evaluation of. injured/disabled individuals.