This position integrates national standards for case management scope of services including:  

  

• Utilization Management supporting medical necessity and denial prevention   

• Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction  

• Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care    

• Compliance with state and federal regulatory requirements, TJC accreditation standards and our company policy   

• Education provided to physicians, patients, families and caregivers  

  

  

  

   

  

  

  

  

Position Qualifications:  

  

Required qualifications include an active Registered Nurse license with at least two years acute hospital case management leadership experience.   MSN preferred. Accredited Case Manager (ACM) preferred. McKesson InterQual® experience preferred.  Five years acute hospital case management experience preferred.  Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy.   Business planning experience preferred.