What are the responsibilities and job description for the Regional Case Manager position at OneDigital | Resourcing Edge?
This position will perform the responsibilities listed below for all Arizona facilities
Job OverviewHere at Exceptional Healthcare, we strive for excellence in the industry. We are a micro hospital with 3 Arizona facilities located in Bullhead City, Maricopa, and Yuma. We are looking for a unique Case Manager to ensure excellent care and the best patient outcomes. The ideal candidate is an exceptional Case Manager with an interest in developing skill in other areas of hospital management. Areas that either impact or are impacted by case management will be overseen by you to ensure enough work for a full-time role. These areas include Quality/Performance Improvement and Infection Control and Prevention. Exceptional Healthcare is a great place to grow!
Responsibilities
Job OverviewHere at Exceptional Healthcare, we strive for excellence in the industry. We are a micro hospital with 3 Arizona facilities located in Bullhead City, Maricopa, and Yuma. We are looking for a unique Case Manager to ensure excellent care and the best patient outcomes. The ideal candidate is an exceptional Case Manager with an interest in developing skill in other areas of hospital management. Areas that either impact or are impacted by case management will be overseen by you to ensure enough work for a full-time role. These areas include Quality/Performance Improvement and Infection Control and Prevention. Exceptional Healthcare is a great place to grow!
Responsibilities
- Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation
- Communicate patient needs to a variety of care team members and follow up accordingly
- Manage safe, effective discharge plans upon completion of treatment
- Work collaboratively with patients, families, physicians, and nurses to ensure high quality care
- Act as the patient's advocate as it relates to insurance coverage and financial assistance
- Maintain the patient's comprehensive clinical record through detailed documentation
- Coordinate with third party payors on a regular basis
- Serves as a utilization manager to determine appropriateness of admission, level of care and continued stay.
- Maintains a working knowledge of Medicare and private insurance companies and ensures that quality of care is maintained or surpassed
- Coordinate insurance appeals as needed
- Collects quality indicators and variance data and aggregates, reporting data to Utilization Committee and/or appropriate department(s).
- Facilitates Quarterly Utilization Review Committee
- Performs other duties as assigned and accepts new tasks as opportunities for growth.
- Registered Nurse in state of practice
- Certified Case Manager, preferred
- 3-5 years of clinical experience, preferably in case management, or related experience
- Ability to walk and stand 50-80% of the time
- Proficient computer skills including experience with Microsoft Excel
- Strong written and verbal communication skills
- Excellent clinical assessment and analytical skills
- 8-hour shift Monday through Friday (9AM - 5PM), varies depending organizations needs
- Weekend availabilityif needed
- Occasionally travel between different Arizona facilities
- Health insurance
- 401(k)
- Dental insurance
- Vision insurance
- Life insurance
- PTO
