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Clinical Case Manager

2 months ago

Arcadia, United States Methodist Hospital Full time
Job Summary

We are seeking a highly skilled Clinical Case Manager to join our team at Methodist Hospital. The successful candidate will be responsible for coordinating patient care, managing utilization review, and facilitating discharge planning to ensure seamless transitions and optimal patient outcomes.

Key Responsibilities
  • Collaborate with interdisciplinary teams to develop and implement patient care plans
  • Conduct thorough assessments of patient needs and develop individualized plans to address those needs
  • Coordinate with payers and other stakeholders to ensure timely and accurate reimbursement
  • Monitor patient progress and make adjustments to care plans as needed
  • Facilitate communication between patients, families, and healthcare providers to ensure informed decision-making
  • Identify and address potential barriers to care, including social determinants and resource utilization
  • Develop and implement strategies to improve patient satisfaction and outcomes
  • Participate in quality improvement initiatives to enhance patient care and reduce costs
Requirements
  • Bachelor's degree in nursing or related field
  • Current RN licensure in the state of California
  • Minimum three years of experience in utilization review and discharge planning
  • Strong analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work independently and as part of a team
Preferred Qualifications
  • Professional certification as a case manager
  • Experience with electronic health records and other healthcare software
  • Knowledge of managed care reimbursement and regulatory requirements