Air Combat Effectiveness Consulting Group, LLC
Case Manager, RN
Air Combat Effectiveness Consulting Group, LLC, Whittier, California, us, 90607
Overview
Under the general supervision of the case management Director, acts as a patient advocate/case manager to hospital clients. This autonomous role coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost-efficient patient outcomes. It looks for opportunities to reduce costs while ensuring the highest quality of care is maintained. The position applies review criteria to determine medical necessity for admission and continued stay, provides clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare, and assists in the identification of appropriate utilization of resources across the continuum of care. The role works collaboratively with interdisciplinary staff internal and external to the organization and participates in quality improvement and evaluation processes related to the management of patient care. Responsibilities
Act as a patient advocate/case manager to hospital clients. Coordinate, negotiate, and procure services and resources for complex patients. Facilitate achievement of quality and cost-efficient patient outcomes. Apply review criteria to determine medical necessity for admission and continued stay. Provide clinically based case management, discharge planning, and care coordination. Assist in the identification of appropriate utilization of resources across the continuum of care. Collaborate with interdisciplinary staff internal and external to the organization. Participate in quality improvement and evaluation processes related to patient care management. Qualifications
Two years of Case Management experience in an acute care environment preferred. Demonstrated skills in negotiation, communication (verbal and written), conflict resolution, interdisciplinary collaboration, management, creative problem solving, and critical thinking are required. Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis is essential. Familiarity with utilization management as it relates to third-party payers is necessary, with experience in managed care preferred. Excellent verbal and written communication skills are required, along with the ability to adapt to changing priorities and regulations. BSN or MSW preferred. Current California RN and BLS certification required.
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Under the general supervision of the case management Director, acts as a patient advocate/case manager to hospital clients. This autonomous role coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost-efficient patient outcomes. It looks for opportunities to reduce costs while ensuring the highest quality of care is maintained. The position applies review criteria to determine medical necessity for admission and continued stay, provides clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare, and assists in the identification of appropriate utilization of resources across the continuum of care. The role works collaboratively with interdisciplinary staff internal and external to the organization and participates in quality improvement and evaluation processes related to the management of patient care. Responsibilities
Act as a patient advocate/case manager to hospital clients. Coordinate, negotiate, and procure services and resources for complex patients. Facilitate achievement of quality and cost-efficient patient outcomes. Apply review criteria to determine medical necessity for admission and continued stay. Provide clinically based case management, discharge planning, and care coordination. Assist in the identification of appropriate utilization of resources across the continuum of care. Collaborate with interdisciplinary staff internal and external to the organization. Participate in quality improvement and evaluation processes related to patient care management. Qualifications
Two years of Case Management experience in an acute care environment preferred. Demonstrated skills in negotiation, communication (verbal and written), conflict resolution, interdisciplinary collaboration, management, creative problem solving, and critical thinking are required. Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis is essential. Familiarity with utilization management as it relates to third-party payers is necessary, with experience in managed care preferred. Excellent verbal and written communication skills are required, along with the ability to adapt to changing priorities and regulations. BSN or MSW preferred. Current California RN and BLS certification required.
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