MUST have at least 3 yrs of acute care/hospital CM experience.
Evaluates the clinical status of patients using nationally developed criteria to determine clinical progression and need for continued inpatient care. Uses information about clinical condition, prior level of functioning and anticipated treatment plan to support effective transition to other levels of care.
Experience in utilization review, discharge planning and/or case management is required.
Knowledge of common disease processes, knowledge of health care delivery systems, demonstrates understanding of common reimbursement methodologies. Able to manage competing priorities and effectively prioritizes work.
Basic computer skills with willingness to learn Financial, Case Management, and Emergency Room systems and order entry systems.