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Larkin Community Hospital is Hiring a Case Manager (Full-Time) Near Miami, FL
- Experience
- Previous C.M. Experience
- Substantial clinical experience
- Education
- Bachelor's degree (required)
- Masters (preferred)
- Licensing
- Foreign Medical Graduate or Registered Nurse (preferred)
- CCM (Certified Case Manager) (preferred)
- ACM (Accredited Case Manager) (preferred)
- Bilingual (English/Spanish) (preferred)
- Performs and documents patient assessment within 24 hours of admission
- Checks prior authorizations initiative by admitting
- Knowledge navigating and using payer portals
- Performs concurrent reviews
- Contacting all HMO’s on a daily basis and provides clinical information to obtain insurance authorization for the patient’s admission and continued stay
- Indicates the appropriate level of care and utilization of services needed
- Establishes criteria for medically necessary services
- Knowledgeable of Milliman Care and Interqual Guidelines
- Develops a plan of care for patients from admission to discharge.
- Promotes the most efficient and cost-effective use of services
- Curtails the performance of inappropriate and/or duplicate services
- Encourages standardization of medical practice patterns
- Enhances the quality of healthcare
- Performs concurrent reviews for patients to ensure that extended stays are medically justified and are documented in patient's medical records.
- Calculates and manages the lengths of stay and continued-stay days for patients.
- Evaluating the patient’s condition and readiness for discharge planning
- Develops discharge plans
- Communicate and assist the physicians in the planning and coordination of patients discharge planning
- Management of transfer procedures
- Management of the guardianship process
- Able to discuss and educate patient/family regarding discharge planning and resources available after discharge. Clearly specifies all the information discussed with the patient and/or family regarding the patient’s discharge plan.
- Participates in PI programs through the identification of opportunities for improvement, data collection, evaluation of findings, improving the process, applying knowledge and incorporates into practice
- Scheduling Peer-to-Peer reviews with payors
- Proactively identifying and resolving issues that could lead to denials
- Familiarity with Medhost electronic medical records
- Extensive medical knowledge
- Self-driven (work and education)
- Keeps knowledge up to date by reading literature and participating in outside continued education meetings, training, and conferences
- Working knowledge of regulatory agencies
- Excellent human relations and communication skills (verbal and written) to maintain good rapport and effective working relationships with medical staff, nursing staff, and other ancillary department staff throughout the hospital
- Excellent organizational skills and attention to detail
- Ability to convey care plan to physicians and the medical team
- Proficient with Microsoft Office Suite or related software.
- Integrity
Job Summary
Full Time
Hospital
$83k-101k (estimate)
07/27/2024
08/24/2024
larkinhospital.com
HIALEAH, FL
1,000 - 3,000
1967
Private
OAKLEY G SMITH
$200M - $500M
Hospital
Related Companies
About Larkin Community Hospital
Larkin Community Hospital is a general medical and surgical teaching hospital that provides healthcare services.
The job skills required for Case Manager (Full-Time) include Scheduling, Discharge Planning, Microsoft Office, Communication Skills, Initiative, Organizational Skills, etc. Having related job skills and expertise will give you an advantage when applying to be a Case Manager (Full-Time). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Case Manager (Full-Time). Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Case Manager (Full-Time) positions, which can be used as a reference in future career path planning. As a Case Manager (Full-Time), it can be promoted into senior positions as a Case Management Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Case Manager (Full-Time). You can explore the career advancement for a Case Manager (Full-Time) below and select your interested title to get hiring information.
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