RN Case Mgr - Division
Location: Charleston South Carolina
Description: Trident Medical Center is looking of RN Case Mgr - Division right now, this career will be placed in South Carolina. More complete informations about this career opportunity kindly read the description below. The Case Management Center Case Manager (CM) role supports the SATL Case Management departments in admission review adhering to medical necessity and Corporate Compliance guidelines! . This virtual role reviews new patient admissions using Meditech and other information sources and integrates patient clinical data with the appropriate selection of InterQual (IQ) Criteria. The CM will expedite timely response on cases requiring external physician advisor reviews and/or follow up of cases with status determination after normal business hours. The CM will be involved in process design to allow the Resource Center Specialist to contact payers for authorization days based on clinical data provided. As reviews are completed, if issues related to conditions not clearly documented as present on admission (POA) placing risk for hospital acquired conditions (HAC) will be communicated back to the hospitals (CDI, CM and quality) for timely intervention. In addition, patients that require special needs, such as social work intervention will be referred to the hospital team. The CM will also work with the Resource Specialist to complete eRequest worklists for timely ! completion. This role will also involve becoming a subject mat! ter expert in InterQual and certified trainer as well in MIDAS. As such travel may be involved to the hospitals 1-2 times/year for training.
The CM has a demonstrated ability in use of InterQual Criteria.
Qualifications
Position Requirements:
Licensure/Certification/Registration:
RN required and active license.
ACM, CCM or CPUR also preferred
Education
:
Graduate of an accredited School of Nursing.
Bachelor of Science in Nursing degree preferred
Experience and Qualifications:
a)
Performs in accordance with delineated job responsibilities and satisfactorily completes a yearly evaluation based on these responsibilities.
b)
2 years experience in acute care setting and/or insurance in Case Management required
c)
Demonstrates analytical and critical thinking abilities with pro-active decision making and negotiation skills.!
d)
Excellent communication skills (oral and written) and customer service oriented
e)
Ability to establish collaborative and effective working relationships.
f)
Ability to work with data for trends and use of reports.
g)
Ability to travel to the SATL hospitals approximately 10% of the time on an annual basis.
h)
Requirement to work late afternoon to evening hour shift.
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Trident Medical Center.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Wed, 14 Aug 2013 06:54:57 GMT