Care Manager
3 weeks ago
Position:
RNCase Manager
Location:
Indianapolis, IN - Hybrid Preferred
Duration:
6-month Contract-to-Hire
Start:
May 6, 2024
Overview:
The RN Case Manager 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.
Qualifications:
Associate's Degree in Nursing or Bachelor's Degree in Social Work required.
Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license OR a Social Work license in the state of Indiana.
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 preferred.
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