RN Case Manager, Acute Care Case Management
1 month ago
VNS Health is seeking a Registered Nurse (RN) Case Manager for Acute Care Case Management.
Job Description
- Assess member needs and identify solutions for high quality and cost-effective health care services.
- Manage providers, members, team, or care manager generated requests for medical services and render clinical determinations.
- Deliver timely notification detailing clinical decisions and coordinate with management, subject matter experts, physicians, member representatives, and discharge planners.
- Conduct comprehensive review of requests for services, ensuring medical necessity and appropriateness of admissions, treatment, and level of care.
- Participate in case conferences with management and identify opportunities for alternative care options.
- Maintain accurate record of all care management and provide case direction and assistance ensuring quality and appropriate service delivery.
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