Case Manager Utilization Nurse

3 weeks ago


Montgomery, United States Jackson Hospital and Clinic Full time
Job Description

Under the direction of the Manager, Clinical Resource Management; the Case Manager is responsible for the activities of utilization management, case coordination and the development and implementation of a discharge plan for an assigned group of patients. The Case Manager serves as a resource for other members of the healthcare team and provides education to team members on issues related to the continuum of care, reimbursement, regulatory agency guidelines and resource use. Through collaboration, the Case Manager assures that the treatment plan is implemented accurately, in a cost effective and efficient manner in order to promote customer satisfaction and prevent delays in care and discharge.

Responsible for reviewing severity of illness and intensity of service indicators to assure that appropriateness of care criteria is met. Documents reviews and discharge planning in the medical record and/or the computer system as appropriate; Collects and maintains data for tracking and reporting for outcome studies and performance improvement.

Requirements

Minimum Bachelor’s degree in Nursing. Experience in working with mental health patients required. Knowledge of the local and State agencies required. Knowledge of CMS and JCAHO Standards required. Case management experience required. Licensed in the State of Alabama as a registered nurse. ICD-9 code book, DSM, computer, and software (including Affinity, Microsoft Word, Excel, and GroupWise), fax, copier and other Office equipment. Equipment used in the delivery of patient care. Computer skills, effective communication skills (verbal and written), time management and critical thinking skills. Working knowledge of healthcare reimbursement, counseling, community resources, continuum of care and team building. Works predominantly indoors with moderate amount of daily walking, standing and under high levels of stress. May be exposed to the risk of communicable diseases, radiation, chemicals and injury related to movement of patients and/or equipment involving a minimum of 50 pounds, or injury from irrational patients or persons. Manual dexterity necessary for typing, writing and manipulation of a mouse. Routine bending, stooping, squatting and overhead use of arms.

  • Montgomery, United States Jackson Hosptial & Clinic Full time

    * Support the Case Management Director and Utilization Review Program * Monitors patient results, optimizing resource distribution and implementing continuing care plans to meet patients' post-discharge needs * Utilizes chart review, electronic medical record, patient/family interviews, along with the medical group data * Organizes plans and prioritizes...


  • Montgomery, United States Encompass Health Full time

    Sign on Bonus $10,000. 00 As a member of Senior Leadership, the Director of Case Management (DCM) is responsible for the day to day operations and human resource management of the department of Case Management. With a central focus on census management, patient care outcomes, and key care indicators, the DCM oversees the interdisciplinary plan of care and...


  • Montgomery, United States Encompass Health Full time

    Sign on Bonus $10,000. 00 As a member of Senior Leadership, the Director of Case Management (DCM) is responsible for the day to day operations and human resource management of the department of Case Management. With a central focus on census management, patient care outcomes, and key care indicators, the DCM oversees the interdisciplinary plan of care and...


  • Montgomery, United States Encompass Health Full time

    Job DescriptionJob DescriptionSign on Bonus $10,000. 00As a member of Senior Leadership, the Director of Case Management (DCM) is responsible for the day to day operations and human resource management of the department of Case Management. With a central focus on census management, patient care outcomes, and key care indicators, the DCM oversees the...


  • Montgomery, United States Marvel Consultants Full time

    Director Case Management - $10,000 Sign-on! Plus bonus incentive program!Community hospital part of a larger system looking to bring on a Director Case Management. Will oversee a team of 7 full time case managers, plus 3 PRN for the weekends. Case Managers carry a caseload of about 12 patients, and this Director does not carry a caseload, all...


  • Montgomery, United States Marvel Consultants Full time

    Director Case Management - $10,000 Sign-on! Plus bonus incentive program!Community hospital part of a larger system looking to bring on a Director Case Management. Will oversee a team of 7 full time case managers, plus 3 PRN for the weekends. Case Managers carry a caseload of about 12 patients, and this Director does not carry a caseload, all...


  • Montgomery, United States Marvel Consultants Full time

    Director Case Management - $10,000 Sign-on! Plus bonus incentive program!Community hospital part of a larger system looking to bring on a Director Case Management. Will oversee a team of 7 full time case managers, plus 3 PRN for the weekends. Case Managers carry a caseload of about 12 patients, and this Director does not carry a caseload, all...


  • Montgomery, United States CVS Health Full time

    Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we...

  • Case Manager

    2 days ago


    Montgomery, United States Jackson Hosptial & Clinic Full time

    Under the direction of the Manager, Clinical Resource Management; the Case Manager is responsible for the activities of utilization management, case coordination and the development and implementation of a discharge plan for an assigned group of patients. The Case Manager serves as a resource for other members of the healthcare team and provides education to...


  • Montgomery, United States Jackson Hospital and Clinic Full time

    Job Description The Denial Management Nurse is responsible for developing and implementing a centralized program to promote greater efficiency with completing, tracking, and reporting clinical denial reviews to determine appropriate appeal of patient accounts. This individual will combine clinical, business, and regulatory knowledge and skill to reduce...


  • Montgomery, United States Jackson Hospital Full time

    Job Description The Denial Management Nurse is responsible for developing and implementing a centralized program to promote greater efficiency with completing, tracking, and reporting clinical denial reviews to determine appropriate appeal of patient accounts. This individual will combine clinical, business, and regulatory knowledge and skill to reduce...


  • Montgomery, United States Ascension Full time

    Details Department: Case Management Schedule: 20 hours weekly; 8:00am-4:30pm, 9:00am-9:30pmHospital: Ascension Mercy Medical CenterLocation: Aurora, IL Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental...


  • Montgomery, United States American Consultants Full time

    Job DescriptionJob DescriptionRN-Utilization Review Manager- ALAmerican Consultants is looking for an RN for a Utilization Review Manager for a health care system in Alabama.Summary:The RN – Utilization Review Nurse Manager shall manage the daily Utilization Review and Appeals Management processes for the facilities. This individual shall administer...


  • Montgomery, United States Ascension Full time

    Details Department: Case Management Schedule: 9:00am-9:30pm, 40 hours weeklyHospital: Ascension Mercy Medical Center Location: Aurora, ILBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave &...

  • Case Manager

    1 month ago


    Montgomery, United States Montgomery Area Mental Health Authority, Inc Full time

    Job DescriptionJob DescriptionThis is responsible, professional work as a direct services provider and an information and referral agent for targeted populations that are considered chronically mentally ill, being released from incarceration, and need assistance transitioning into the community.DESCRIPTION OF DUTIES:Identify eligible individuals.Visit...


  • Montgomery, United States Marriott International Full time

    Additional Information Nurse CARE Manager (CARE - Coordinated Action and Response)Registered Nurse license required Job Number 24069165 Job Category Finance & Accounting Location Marriott International HQ, 7750 Wisconsin Avenue, Bethesda, Maryland, United States VIEW ON MAP Schedule Full-Time Located Remotely? Y Relocation? N Position Type...

  • Warehouse Utility

    14 hours ago


    Montgomery, United States Coca-Cola Bottling UNITED Full time

    Division: Southern Pine Department : Montgomery Warehouse Team 4 Work Schedule:  Sunday to Thursday, Sun 7AM until complete, Mon to Fri 2:30 to 10PM Why you will love Coca-Cola UNITED?About us:Privately owned and operated with 100+ years of historical strength and stabilityDedicated to supporting internal career growth through on job training, learning...


  • Montgomery, United States River Region Psychiatry Associates Full time

    Job DescriptionJob DescriptionDescription:River Region Psychiatry Associates is currently looking for PMHNP candidates for PRN weekend coverage in Charleston, SC.POSITION SUMMARYA Nurse Practitioner (NP) is an advanced practice registered nurse with specialized training in diagnosing and treating various health conditions. Functioning with a high degree of...


  • Montgomery, United States State of Alabama Full time

    The Human Resources Case Management Technician is a permanent, full-time position with the Department of Human Resources. Positions are located throughout the state. This is advanced technical paraprofessional work providing case management support in one of DHR's social service programs. Employees in this class provide caseload and workload support to...


  • Montgomery County, United States Area Agency on Aging, PSA2 Full time

    Job DescriptionJob DescriptionThe Area Agency on Aging team hires caring, compassionate Registered Nurses to help our consumers receive the services they need to improve their lives. Join our team and get a supportive network of supervisors and co-workers, flexible schedule, and a career that makes a difference in the community. Skills and experience are...