Full Time | Ambulatory Healthcare Services2 Days Ago
Save
CoxHealth is Hiring a Case Manager Float Near Springfield, MO
Summary
Best in Class Work Environment
5x Modern Healthcare Best Places to work
America’s Greatest Workplaces 2023 – Newsweek
Best Employers for New Grads 2023- Forbes
Greatest Workplace for Women 2023 - Newsweek
Benefits
Robust, fully customizable benefits package including Medical/Vision/Dental and more!
No cost eCare visits
Employer-provided mental health services for employees and eligible family members
Retirement with employer match
Tuition discounts and reimbursement available for continuing your education
Free and convenient parking
CoxHealth Fitness Center and Child Care discounts
Onsite delivery for CoxHealth Pharmacies and 1906 Employee Store
Job Summary
The nurse case manager collaborates with the physician and members of the multidisciplinary team to facilitate progression-of-care; monitors the patient's progress, intervening appropriately to ensure that the plan of care and services provided are patient focused, high quality, evidence based, appropriate to patient needs, efficient, and cost effective. Conduct concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff, accrediting bodies, and other state agencies. Prospectively or concurrently determines the appropriateness of inpatient or observation services following review of relevant medical documentation, medical guidelines and insurance benefits and communicates information to payers in accordance with contractual obligations. Serve as a resource to the physicians and provide education and information on resource utilization, national and local coverage determinations, and use of hospital admission criteria. The nurse case manager will float to different departments as needed.
Job Requirements
Education
Required: Graduate of an accredited school of nursing
Preferred: Bachelor's of Nursing with knowledge of InterQual Level of Care Criteria and/or Milliman Care Guidelines and of local/national coverage determinations; familiarity with SIMS procedure indicators and inpatient only listings.
Experience
Required: Minimum of 3 years hospital experience
Skills
Excellent interpersonal skills, including ability to be genuine and empathetic
Excellent communication (verbal and written) skills with attention to detail
Computer skills
Ability to interact professionally and contribute to the interdisciplinary team