Medical Management Coordinator Position Available In Philadelphia, Pennsylvania

Job Details The Utilization Management Access RN under the direction of the Utilization, proactively communicates with members of the healthcare team to ensure appropriate medical necessity for patients in beds. Serves as an effective liaison to ensure continuity and integration of services and accurate assignment of patient status. Communicates with payers and patient/family/healthcare team regarding payer information as necessary. Job Description Essential Functions ? Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. ? Collaborates with all members of multidisciplinary healthcare team to review all potential direct/scheduled inpatient admissions, and non-emergent external transfers to determine medical necessity for admission and appropriate level of care. ? Works with the members of the department and healthcare team to assist in finding alternatives to an inpatient admission when the patient does not meet medical necessity for hospital admission.

Education:

Bachelors of Nursing Experience:

Minimum 5 years clinical experience required and 3-5 years of experience as a hospital Case Manager. Work Shift Workday Day (United States of America) Worker Sub Type Regular Primary Location Address 5501 Old York Road, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow’s professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University , home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health , nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educa?tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. Benefits At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.