Job Overview We are seeking a dedicated and energetic Case Manager, Health Educator (PNCC), Billing & Compliance Specialist to join our dynamic healthcare team. This multifaceted role combines clinical case management, patient education, billing oversight, and compliance monitoring to ensure exceptional patient care and operational excellence. The ideal candidate will thrive in a fast-paced environment, demonstrating strong communication skills, clinical expertise, and a passion for improving health outcomes. You will play a vital role in coordinating care, educating patients and families, managing documentation, and ensuring adherence to healthcare regulations. This position offers an exciting opportunity to make a meaningful impact on diverse patient populations while working within a collaborative and supportive team. Duties Conduct comprehensive patient assessments, including medical history review, physiology evaluation, and diagnostic evaluations to inform personalized care plans. Develop and implement case management strategies that promote optimal health outcomes across inpatient, outpatient, post-acute, and community settings. Provide health education tailored to individual needs, including managing chronic conditions such as substance use disorders, mental health conditions, and disabilities. Coordinate discharge planning by collaborating with healthcare providers, community resources, social workers, and families to ensure seamless transitions of care. Manage electronic health records (EHR) with accuracy and confidentiality in compliance with HIPAA regulations; document all patient interactions thoroughly. Oversee billing processes and ensure compliance with healthcare policies; review medical records for proper coding and documentation accuracy. Facilitate utilization management by reviewing clinical documentation for appropriateness of services and supporting authorization processes. Assist patients with intake procedures, community resource navigation, and connecting them to social services or behavioral health supports as needed. Prioritize tasks effectively in a high-volume environment while maintaining excellent patient service and communication standards. Collaborate with multidisciplinary teams in hospital medicine, emergency medicine, ICU, PICU (Pediatric Intensive Care Unit), trauma centers (Level I & II), and other specialized units to support comprehensive care delivery. Qualifications Proven hospital experience with acute care environments such as ICU, emergency departments, or trauma centers; Level I & II trauma center experience preferred. Strong background in clinical case management within inpatient or outpatient settings; experience working with children and individuals with disabilities or substance use disorders is highly desirable. Knowledge of medical terminology, physiology, diagnostic evaluation techniques, and behavioral health principles. Experience working with electronic health records (EHR) systems; familiarity with EMR/EHR management is essential. Certified in Basic Life Support (BLS) and CPR; additional certifications in addiction counseling or mental health counseling are advantageous. Excellent client communication skills; adept at working with diverse cultural backgrounds and family members during discharge planning or intake processes. Ability to prioritize tasks efficiently while maintaining high standards of patient service and confidentiality under HIPAA guidelines. Managed care knowledge combined with experience in utilization management ensures appropriate resource allocation. Strong social work skills including community resource coordination in health services social work; experience working with individuals from diverse backgrounds is preferred. Join us to be part of a passionate team committed to delivering compassionate care while advancing your professional growth in a vibrant healthcare setting!

Pay:

$9.00 - $15.00 per hour

Work Location:

In person