Description: Under the general supervision of a Lead Case Manager, serves, as a link between provider and payor organizations, physicians and the community in the provision of patient health needs. While this role does focus on utilization management/review, discharge planning and clinical outcome achievement, the Case Manager uses a breadth of skill and financial management tools to address a continuum of care and centralizes an approach for merging resources. The Case Manager handles problems by solving, teaching and facilitating the continuum of care. The Case manager screen all new admissions for appropriate orders of status and bed placement.
License as a Registered Nurse in the state of Georgia.
Masters degree in Nursing and one year related nursing experience.
Bachelor's Degree in Nursing and three years related nursing experience.
Case management experience.
Experiences in utilization management/review, fiscal management, patient accounts, coding or discharge planning preferred. InterQual experience required.