Hospital Case Manager

2 days ago


Greenville, South Carolina, United States Prisma Health Full time
Hospital Case Manager Job Summary

The Hospital Case Manager plays a critical role in ensuring the efficient and cost-effective progression of patients through the continuum of care. This position requires collaboration with physicians, clinical staff, and payors to deliver high-quality, cost-effective care.

Key Responsibilities:
  • Participate in discharge planning activities for patients with complex medical issues to ensure timely discharge and linkage with post-acute care providers.
  • Consult with interdisciplinary teams, physician advisors, and administrative leadership to resolve barriers and ensure efficient care progression.
  • Collaborate with physicians to develop effective working relationships and provide expertise on payor and regulatory guidelines.
  • Proactively identify and resolve delays and obstacles during the hospital discharge planning process.
  • Monitor patient progress and intervene as necessary to ensure high-quality, efficient, and cost-effective services.
  • Advocate for patient and family empowerment and independence to make autonomous healthcare decisions and access needed services.
  • Maintain current knowledge of changes in state and federal regulatory requirements related to case management services.
  • Promote effective and efficient utilization of clinical resources to ensure quality, cost-effective care.
  • Ensure patient goals are set with patient/family, negotiate healthcare resources, and educate patient/family regarding options of care.
Requirements:
  • Bachelor's degree in nursing, preferred
  • Three (3) years acute care nursing experience
  • South Carolina RN license

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