Case Manager - Care Coordination - Full Time 8 hours Days (Union, Non-Exempt)
Core
Coordinate patient care, manage length of stay, and facilitate discharge planning and utilization management for a designated caseload to ensure efficient, cost-effective care.
Role type
Senior Case Manager (Care Coordination & Utilization Management)
Builds
Patient care plans, discharge pathways, and utilization management decisions
Domain
Healthcare / Hospital Operations
Deliverable
client delivery
Required skills
Utilization management, discharge planning, care coordination, InterQual criteria application, payer authorization, performance improvement, data analysis, conflict resolution
Preferred skills
Clinical experience in acute hospital utilization review and discharge planning
Technologies
Affinity GUI
Responsibilities
Monitor length of stay and resource utilization; facilitate pre-certification and payer authorization; coordinate multidisciplinary discharge planning; apply InterQual criteria for admission/stay appropriateness; resolve barriers to timely care and discharge; manage at-risk population screening and referrals; ensure accurate clinical documentation for reimbursement.
Seniority
Mid-Senior level, hands-on IC