Case Manager - Union General Hospital - Full Time
Union General Hospital•Blairsville, GA
•Onsite
About The Position
The primary purpose of this job is to do case management as well as social services activities and utilization review duties.
Requirements
- Associates degree/Bachelor degree in Nursing
- Licensed Registered Nurse (RN)
- ACLS and BLS certifications
Nice To Haves
- Two years Case Management experience
- Med/Surg background
- Knowledge of Cerner and MCG (Indicia)
- Case Management experience
Responsibilities
- Complete chart reviews to assess medical necessity for the level of care and services provided using criteria as directed by the patient's payor sources.
- Document in the UR note and complete certifications or forward information to payor's as required by payor source.
- Assist quality department in compliance with core measures.
- Improve concurrent documentation to optimize quality of patient care and accurate reimbursement.
- Participate in denial management and complete the appeals process.
- Assess discharge needs of patients, document in medical record, meet discharge needs, and participate in multidisciplinary team meetings.
- Utilize strategies to decrease re-admissions (complete risk assessments on inpatients, obtain referrals as needed, coordinate care with patient, family and doctor.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
