Case Manager, Case Management Department, Full Time, Day Shift, Job ID:

Palmetto General Hospital • Hialeah, FL

1d

About The Position

Performs Case Management activities to assure medical necessity of admissions and appropriateness of continued stay utilizing the Interqual Criteria guidelines. Monitors the utilization of resources of all patients reviewed. Maintains confidential communication with physicians and multi-disciplinary personnel to meet individual needs or the patients served. Functions as an independent contributor as well as a team member.

Requirements

• Communication is an essential skill requiring the ability to see, hear, and speak.
• Fluent in written and spoken English.
• Must be able to fulfill the essential functions of the position.
• Current Florida RN Licensure.
• Must possess a solid clinical background to accomplish extensive Medical Record review.
• Computer skills preferred
• Ability to effectively communicate in writing and orally with all levels of the organization
• Must clear background and drug test required.

Nice To Haves

• Possess three or more years of acute care hospital experience preferred.
• Familiar with the operations of the healthcare industry and healthcare delivery systems.
• Able to use the medical record in order to obtain clinical information to perform Interqual reviews.
• Utilize Outlook, and the computer based systems (AllScripts) to perform reviews.
• Work experience in Medical-Surgical, Telemetry, Critical Care, and/or Pediatrics, NICU preferred.

Responsibilities

• Performs Case Management activities to assure medical necessity of admissions
• Monitors the utilization of resources of all patients reviewed
• Maintains confidential communication with physicians and multi-disciplinary personnel

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed