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Director, Case Management
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Confidential
Sun City West, AZ (In Person)
$62,820 Salary, Full-Time
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Job Description
Overview We are seeking a dedicated and highly skilled Case Manager to join our healthcare team. The ideal candidate will possess extensive clinical experience, particularly within hospital and acute care settings, and demonstrate a strong understanding of patient-centered case management practices. This role involves coordinating comprehensive care plans, facilitating discharge processes, and ensuring optimal utilization of healthcare resources. The successful applicant will play a vital role in improving patient outcomes while maintaining compliance with healthcare regulations and standards. Responsibilities Conduct thorough patient assessments to develop individualized care plans that address medical, psychological, and social needs. Coordinate multidisciplinary team efforts to ensure seamless delivery of care across hospital departments, including ICU, pediatrics, and trauma units. Manage discharge planning processes to facilitate timely patient transitions from hospital to home or other care facilities. Utilize electronic health record (EHR) systems and electronic medical records (EMR) to document patient progress, interventions, and outcomes accurately. Perform utilization review and management to optimize resource use while adhering to insurance requirements and healthcare policies. Collaborate with social workers, behavioral health specialists, and managed care organizations to support patient needs comprehensively. Ensure compliance with HIPAA regulations and maintain confidentiality of sensitive patient information at all times. Apply clinical knowledge of medical terminology, CPT coding, ICD-9/10 coding systems, and discharge procedures to facilitate accurate documentation and billing. Assist in intake processes for new patients requiring complex case management services within hospital medicine or hospice care settings. Support patients through the continuum of care by providing education on treatment plans, medication management, and follow-up procedures. Skills Extensive experience in critical care environments such as ICU, PICU, or Level I/II trauma centers. Strong background in hospital nursing or emergency medicine with knowledge of acute care protocols. Proficiency in EMR/EHR systems along with familiarity with ICD coding (ICD-9/10), CPT coding, and utilization review tools. Expertise in discharge planning, intake procedures, and case management within hospital or hospice settings. Knowledge of behavioral health issues, social work practices, and managed care processes. Ability to navigate complex healthcare regulations including HIPAA compliance effectively. Excellent communication skills for engaging with patients, families, healthcare providers, and insurance representatives. Demonstrated ability to prioritize tasks efficiently in high-pressure environments such as Level I trauma centers or emergency departments. Familiarity with pediatric care requirements including PICU protocols and Level II trauma center standards is preferred. Join our team as a Case Manager to make a meaningful difference in patient lives through expert coordination of care and resource management!