POSITION SUMMARY

Assume primary responsibility of cases for documentation of appropriate medical necessity for the inpatient and/or observation status in the acute hospital setting.

DUTIES AND RESPONSIBILITIES

Communications with physician, ancillary staff, and payers and assists in arranging transfers or alternate placement when indicated Assures proper level of care assignment. Facilitates with Case Managers and other allied health professionals to promote and ensure that quality care is provided, and outcomes are achieved in a timely and cost-effective manner Supports hospital goals and objectives in compliance with regulatory guidelines Works in collaboration with all healthcare disciplines to assure a continuum of appropriate and timely services Assess appropriateness, quality, and cost effectiveness of proposed hospital, medical and corporate goals and objectives

EXPERIENCE AND EDUCATION

Prefer a minimum of four years' experience in hospital setting One-year experience in utilization management/case management is preferred Case Manager must be a graduate of an accredited school of Nursing, Health Information Management, or Social Work RN preferred