As a member of the clinical team, completes assessment and service plan and implements services to members in accordance with their individualized service plan (ISP). Communicates and documents member's progress toward their recovery.
In this role, you will evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay utilizing standard criteria. Identifies issues that may delay patient discharge and facilitates resolution of these issues.
In this role, you will be helping Obtain initial authorizations from HMO's / Medical Groups, managing referrals and negotiating with HMO and managed care Case Managers, Tracking and managing care provided to ensure maximum efficiency, proactive and effective service provided to Residents with skilled healthcare needs and performing a key leadership role during managed care plan meetings.
This position assesses the patients plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patients health care needs.
In this role, you will be responsible to
assist members with the transition from a care facility back to their home. Support members with condition education, medication reviews and connections to resources.
In this role, the successful candidate will communicate and document member's progress toward their recovery; complete assessment and service plan and implements services to members in accordance with their individualized service plan (ISP).
In this role, the selected candidate will maintain patient tracking addressing: open/close dates; diagnosis codes; treatment plan; annual assessment; demographics; and health insurance coverage according to RBHA guidelines.
In this role, you will maintain accurate record (system) of case management interventions including cost/benefit analysis, savings, and data collection. Adheres to quality assurance standards and all case management policy and procedures.