Case Manager - Care Coordination - Full Time 8 hours Day (Union, Non-Exempt)
Core
Coordinate patient care, utilization management, and discharge planning to enhance clinical outcomes, manage costs, and ensure timely reimbursement.
Role type
Case Manager (Care Coordination)
Builds
Patient care plans, discharge plans, and utilization management decisions
Domain
Healthcare / Hospital Operations
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Utilization management, discharge planning, care coordination, InterQual criteria application, payer communication, data analysis, conflict resolution
Preferred skills
Clinical experience in utilization review and discharge planning in acute hospitals
Technologies
Affinity GUI
Responsibilities
Facilitate pre-certification and payer authorization processes; monitor length of stay and resource utilization; coordinate multidisciplinary discharge planning; apply InterQual criteria for admission/stay appropriateness; resolve barriers to timely care and discharge; manage patient caseloads and communicate with physicians, nursing, and payers; document care plans and performance indicators.
Seniority
Mid-level, hands-on IC
