What are the responsibilities and job description for the Case Management Specialist - Part Time Weekdays position at ScionHealth?
Discharge Planning and Utilization Management
In this role, you will conduct comprehensive, ongoing assessments of patients to provide timely and safe discharge planning. You will provide comprehensive discharge planning for each patient, utilizing critical thinking to develop and execute effective plans. Additionally, you will coordinate and communicate with patients/families efficiently and effectively.
You will conduct medical necessity reviews for appropriate service utilization from admission through discharge. This role promotes effective and efficient utilization of clinical resources, conducting timely and accurate clinical reviews, care collaboration, and continued stay authorization with payors.
Required Skills and Qualifications:
In this role, you will conduct comprehensive, ongoing assessments of patients to provide timely and safe discharge planning. You will provide comprehensive discharge planning for each patient, utilizing critical thinking to develop and execute effective plans. Additionally, you will coordinate and communicate with patients/families efficiently and effectively.
You will conduct medical necessity reviews for appropriate service utilization from admission through discharge. This role promotes effective and efficient utilization of clinical resources, conducting timely and accurate clinical reviews, care collaboration, and continued stay authorization with payors.
Required Skills and Qualifications:
- Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
- Knowledge of Medicare benefits and insurance processes and contracts.
- Knowledge of accreditation standards and compliance requirements.
- Ability to demonstrate critical thinking, prioritization, and time management skills.
