Pre-employment modules may be required for this role. Please upload any certifications or health documents you have to your profile to expedite your on-boarding process.

Additional Details:

Required Skills/Experience:

• 3-5 years clinical experience in medical/surgical nursing, home care, hospital case management and/or previous utilization review experience.
• Must have utilization review and discharge planning experience.

Preferred Credentials:

• BSN preferred.
• ACM or other nationally recognized case management/utilization review certification preferred.

Unit Details:

• Coordinates concurrent utilization management activities house-wide and serves as the main link between the patient, health care team, organization, and payors during the patient's hospital stay.
• Conducts assessments of patient needs, identifies resources required to transition patients to the next setting, and secures necessary resources.
• Participates in daily care rounds, care conferences, care planning, and inpatient length-of-stay management.
• Works with community organizations to secure durable medical equipment, health insurance authorizations, and transportation.
• Includes focus on hospital reimbursement methods and quality measures applicable to the care management department.

Shift & Scheduling:

• 40 hours per week.
• Variable shifts of either 8:30 to 4:30 or four 10-hour shifts that start at 7:30 am - 5:00 pm.
• No call.
• Weekend and holiday rotation is required.