Case Manager /UR
Minimum qualifications: Graduate of an accredited school of nursing, Active RN, BSN with a minimum of two years in an acute direct patient care delivery system and one year of case management. This position requires a high level of communication skills both written and verbal. Experience with EHR is required, CPSI experience is preferred. Experience with InterQual Evidenced Based Clinical Criteria is required. Must be able to work in a team environment.
Essential Job Functions:
The individual will performs daily pre-admission, admission and concurrent utilization reviews using the appropriate guidelines. Coordinate patient care with physicians, nursing staff and other health care workers as needed. Communicates with physicians on developing individualized plan of care and discharge planning, monitors and documents clinical assessments and makes the appropriate recommendations for change in level of care prior to admission, concurrent reviews and at time of discharge. The individual will ensure continuity of care through communication in rounds and written documentation. Monitors care processes to provide cost effective care implementation. Obtains payer authorization/approvals and responds to appeals when necessary. The individual will communicate with patients, family and caregivers regarding care management. Also, the individual will participates in process improvement practices within the department. Performs other job duties as assigned. Adheres to organizational and departmental policies and procedures.
Work Schedule: Case Manager/UR will work Monday through Friday (This schedule may alter depending on the needs of the organization and will be an hourly position.
Magee General Hospital reserves the right to reevaluate and update job description and change salaried positions to hourly pay status and vice versa with given notice.
Position Type : Full Time
Shift : Day
300 3rd Ave SE
Magee, MS 39111