Case Manager (UR)

University of Tennessee Medical Center • Knoxville, TN

85d

About The Position

The position involves completing clinical reviews for all payors using established criteria. The role requires collaboration with physicians to obtain orders for status changes when appropriate. The individual will provide notifications to payors through various communication methods including telephone, fax, and electronic portals. Additionally, the position entails working with other professional caregiver disciplines to expedite patient flow through the system and efficiently managing multiple platforms. The role also includes answering questions regarding MOON letters when appropriate and providing coverage in needed areas, including the Emergency Department (ED).

Requirements

• BSN required or willing to obtain.
• UR experience preferred.

Responsibilities

• Complete clinical reviews for all payors utilizing established criteria.
• Collaborate with physicians to obtain orders for status changes when appropriate.
• Provide notification to payors via telephone, fax, and electronic portals.
• Collaborate with other professional caregiver disciplines to assist in expediting patient flow through the system.
• Work efficiently out of multiple platforms.
• Answer questions regarding MOON letters when appropriate.
• Float to provide coverage in needed areas, including the ED.

What This Job Offers

• Industry: Hospitals
• Education Level: Bachelor's degree