Case Manager - Care Coordinator - Full Time 8 hours Days (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 Coordinator
Builds
Patient care plans, discharge plans, and utilization management reports
Domain
Healthcare / Hospital Operations
Deliverable
client delivery
Required skills
Utilization management, discharge planning, payer authorization, clinical documentation review, performance improvement analysis, conflict resolution, data-driven decision making, interdisciplinary collaboration
Preferred skills
Knowledge of InterQual criteria, experience with Medicare One-Day admissions, familiarity with Affinity GUI system
Technologies
Affinity GUI
Responsibilities
Facilitate pre-certification and payer authorization processes; manage patient caseloads to optimize length of stay and resource utilization; coordinate multidisciplinary discharge planning; monitor clinical performance indicators and cost metrics; resolve barriers to timely care delivery; communicate with physicians, nursing staff, and external payers; document care plans and transfer details in the Affinity GUI system.
Seniority
Individual Contributor
