Case Manager
Job Location
Department
17 February, 2021
Full Time
Day
272849
Case Manager
This job posting is no longer active.
Job Description
Overview
Plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely and effective discharge planning for patients. Works with third party payers to ensure coverage. Administers education and prevention programs.• Requires current state of Indiana license as a Registered Nurse.
• Certification in Case Management preferred.
• Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
• Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
• Ability to comprehend third party contractual arrangements is preferred.
• Understanding of the third party denial and appeal process is preferred.
• Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS. 3-5 years of experience required.
• Requires strong clinical background in acute care.
We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Qualifications for the Case Manager Role
Overview
Plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely and effective discharge planning for patients. Works with third party payers to ensure coverage. Administers education and prevention programs.- Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.
- Requires current state of Indiana license as a Registered Nurse.
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS. 3-5 years of experience required.
- Requires strong clinical background in acute care.
Indiana University Health is Indiana’s most comprehensive health system, with 15 hospitals and nearly 40,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.
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