Provides utilization review services; assisting with identifying medical necessity for care; identifies appropriateness of current status and coordinates the planning and safe transition process and follow-up. In order to meet the patient’s safety and healthcare needs, the case manager works with the provider, interdisciplinary team, the patient and family to facilitate a plan of current care and coordinate any required follow-on care to promote a balance of quality and cost effective care.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
1. License/Certifications: Active nursing license. Certification in Case Management preferred.
2. Education: Bachelor’s Degree preferred.
3. Experience: Minimum of (5) five years’ experience preferred.
4. Understanding of health care reimbursement preferred
5. Proficient computer and communication skills