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Support and collaborate with the management, medical management and health services team members in the implementation and management of Utilization Management, Case Management, Disease Management, Population Health, Care Coordination, and Care Transition activities.
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
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Prefer prior experience in case management, utilization review, or discharge planning. Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
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Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients’ care throughout the care continuum.
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DescriptionJob SummaryCoordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members.
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Internal Number: 510625 DescriptionJob SummaryCoordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members.
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Is a SME and leads team members in understanding critical components of Managed Care Scheduling Financial Counseling Pre-Certification Admissions/Discharges/Transfers Clinical workflows and documentation Revenue Management Charge Description Master Coding (Diagnosis HCPCS Revenue Codes Procedure Codes Modifiers etc.
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Job Summary: The Case Manager II coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members.
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Job Summary: The Case Manager II PRN coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members.
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Serves as an active member of the Outcome Facilitation Team/Patient Care Multidisciplinary Team and works closely with medical staff, hospital departments and ancillary services in identification and resolution of barriers to discharge, expediting care delivery to avoid delays in timely service provision, and implementing and reporting care coordination, discharge planning and utilization management (UM) activities.
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Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Utilization Management Conducts medical necessity review for appropriate utilization of services from admission through discharge.
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The RN Case Manager is to support the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers.
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Care Manager RN - Case Management, Providence Sacred Heart Medical Center & Children's Hospital, Spokane WA. Functions in a leadership role as a member of a multidisciplinary team to achieve collaborative practice, coordinated care, continuity of care, consistent and/or expected clinical outcomes, efficient management, and quality improvement.
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CASE MANAGER REGISTERED NURSE for our CALIFORNIA Health Plan. Candidates must live in the state of California in San Bernardino or Riverside COUNTY.We are looking for an RN with at least 2 years of relevant Case Management experience.
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Utilize clinical expertise, discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management, and patient advocacy. As a RN Case Manager you'll advocate for patients while collaborating closely with interdisciplinary health care partners, facilities and families to ensure the best possible care experience from admission through discharge and beyond by connecting patients to resources that help them maintain and build on positive outcomes.
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care team utilization management jobs Title: rn case manager in Raleigh, West Virginia
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