About Job
Full job description
JOB RESPONSIBILITIES:
- Provide on-site (hospital, skilled nursing facility) and/or telephonic inpatient case management and concurrent review for identified hospitalized members.
- Monitor medical necessity, appropriateness and efficiency of care using established inpatient guidelines, contacting Supervisor, Physician, Specialist, Hospitalist, and Medical Director as needed.
- Coordinating and assisting with discharging patients from hospitals and SNFs.
- Coordinating transfer of patient to in network facilities when appropriate.
- Participate in discussion of delays / barriers / progression of care at care coordination rounds or in 1:1 meetings with physicians, specialists and/or hospital staff.
- Be knowledgeable of patient’s available benefits / coverage / payor information.
- Be knowledgeable of community programs and resources available to patients within their benefit plan.
Professional Field
Nursing
Other Behavioral, Mental, or Healthcare FieldPatient Focus
Diagnoses
Avoidant Personality Disorder
Therapeutic Approach
Methodologies
ECT
Practice Specifics
Settings
In-patient Non-Psychiatric
In-patient Psychiatric
Research Facilities/Labs/Clinical Trials
Home Health/In-home
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