Nurse Case Manager Care Coordination Part Time Days
Core
Coordinates patient care from admission through discharge, ensuring appropriate levels of care and cost-effective treatment within an acute hospital setting.
Role type
Nurse Case Manager
Builds
Continuum of care pathways for inpatients and observation patients
Domain
Healthcare / Acute Care
Deliverable
client delivery
Required skills
Patient assessment, care planning, interdisciplinary collaboration, utilization management, discharge coordination, insurance verification, resource referral
Preferred skills
Utilization review experience, case management certification, insurance setting experience, bilingualism
Technologies
Milliman criteria, third-party payer review systems
Responsibilities
Assess and plan patient care in collaboration with physicians and multidisciplinary teams; perform utilization management for inpatients and observation patients; coordinate bed placement and patient flow between care levels; review clinical cases against insurance criteria to minimize denials; partner with post-acute care providers for seamless discharge; identify throughput barriers and alert management; educate patients and families on care needs.
Seniority
Individual Contributor, Entry to Mid-level