Catholic Health Services of Long Island

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Care Manager-PD - Util Rev/Care Mgmt/Qlty Assur

at Catholic Health Services of Long Island

Posted: 8/1/2019
Job Status: On Call
Job Reference #: 100017574
Keywords: health

Job Description

6022508

Util Rev/Care Mgmt/Qlty Assur

Bethpage
Bethpage, NY

Per Diem

Day shift

8A-4P

JOB RESPONSIBILITIES:

  • Participates in the development of department and continues updating the department's goals and objectives.
  • Educates staff, physicians, patients and families in the case management process.
  • Reviews new admissions and continued stay patients to determine whether InterQual criteria is met.
  • Interfaces with representatives of third party payors to assist with the certification process and the discharge planning process. Responds to requests for reviews in a timely fashion to avoid denials.
  • Reviews records and interacts with staff and physicians to obtain information about all aspects of patients. Transmits information to third party payors to avoid denials.
  • Participates in rounds with members of other disciplines and identifies areas for improvement.
  • Facilitates communication between patients, families and social workers.
  • Interacts with social workers to affect safe discharge plans.

EXPERIENCE, EDUCATION AND TRAINING:

  • Registered Nurse, NYS license
  • BS in a health related field preferred
  • In-hospital case management and discharge planning experience preferred
  • Excellent written, verbal, statistical and interpersonal skills
  • Certification in case management preferred
  • PRI assessor