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Regional Case Manager

4 months ago

Maricopa, United States Exceptional Healthcare Inc. Full time

**This position will perform the responsibilities listed below for our facility in Maricopa and soon to be facility in Prescott**

**Job Overview**

**Responsibilities**
- Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation
- Communicate patient needs to a variety of care team members and follow up accordingly
- Manage safe, effective discharge plans upon completion of treatment
- Work collaboratively with patients, families, physicians, and nurses to ensure high quality care
- Act as the patient's advocate as it relates to insurance coverage and financial assistance
- Maintain the patient's comprehensive clinical record through detailed documentation
- Coordinate with third party payors on a regular basis
- Serves as a utilization manager to determine appropriateness of admission, level of care and continued stay.
- Maintains a working knowledge of Medicare and private insurance companies and ensures that quality of care is maintained or surpassed
- Coordinate insurance appeals as needed
- Collects quality indicators and variance data and aggregates, reporting data to Utilization Committee and/or appropriate department(s).
- Facilitates Quarterly Utilization Review Committee
- Performs other duties as assigned and accepts new tasks as opportunities for growth.

**Qualifications for Case Manager**
- Registered Nurse in state of practice
- Certified Case Manager, preferred
- 3-5 years of clinical experience, preferably in case management, or related experience
- Ability to walk and stand 50-80% of the time
- Proficient computer skills including experience with Microsoft Excel
- Strong written and verbal communication skills
- Excellent clinical assessment and analytical skills

**SCHEDULE**:

- 8-hour shift Monday through Friday (9AM - 5PM), varies depending organizations needs
- Weekend availability if needed
- Occasionally travel between different Arizona facilities

**BENEFITS**:

- Health insurance
- 401(k)
- Dental insurance
- Vision insurance
- Life insurance
- PTO

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