Case Manager

2 weeks ago

Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time
Job Title: Case Manager

We are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services.

Job Summary:

The Case Manager will work collaboratively with the Utilization Management team, Denial Manager, Physician Advisor, Physician staff, Nursing staff, Case Management, Finance, Clerical Support staff, and payer liaisons to ensure the delivery of high-quality patient care.

Responsibilities:
  • Perform admission and concurrent review to identify medical necessity, level of care, and appropriateness of setting using established criteria and clinical guidelines within 24 hours of admission.
  • Review the admission assessment, collaborate with primary nurse and other healthcare providers to ensure a multidisciplinary plan-of-care is in place to meet identified patient care needs and desired outcomes.
  • Manage observation level of care and work with the attending physician and/or clinical provider caring for the patient to ensure observation status does not exceed 48 hours.
  • Identify system issues that serve as barriers to care and participate in development and implementation of strategies to remove barriers and facilitate performance improvement measures.
  • Monitor efficiencies in scheduling diagnostic procedures and coordination of treatments to facilitate achievement of effective clinical, fiscal, quality, and patient satisfaction goals.
  • Report information generated from the utilization management referral process for LOS data and physician profile database.
  • Collaborate with the unit medical director and/or physician advisor to facilitate achievement of clinical, quality, financial, and patient satisfaction goals.
  • Notify physician when patient does not meet criteria for acute care hospitalization, pursue documentation to justify continued stay within 24 hours.
  • Collaborate with the Physician Advisor to facilitate achievement of clinical, quality, financial, and patient satisfaction goals.
  • Presents "Letters of Non-Coverage (LON) to patients and/or families when acute stay is no longer necessary (Third Party and/or Medicare).
  • Communicate and secure continued stay authorization with Managed Care Organizations.
  • Tracks all carve-outs and submits reason codes for data entry.
  • Serves as a resource to nursing and ancillary staff, providing education on utilization review processes as needed.
  • Provides On-call support for the Transfer Center to evaluate medical necessity and appropriateness when a request is obtained from an outside facility for patient transfer to Christiana Care.
  • Identifies need for patient to be evaluated by other members of the healthcare team and takes appropriate action to facilitate.
Requirements:
  • Bachelor's degree in nursing.
  • Minimum of 3 years recent experience as a Registered Nurse in acute care, adult care setting.
  • Clinical Documentation, Performance Improvement, Case Management, or Utilization Management experience desirable.
  • Completes a minimum of 8 continuing education credits (CEU's) per year in Utilization and/or Case Management.
  • Actively participates in department operational planning work groups.
Working Conditions:

The Case Manager will work in a fast-paced environment with frequent interruptions. The ability to ambulate within the hospital setting, utilize computer equipment/programs, and sit or stand at a computer workstation for long periods of time is required.

Occasional exposure to office materials is expected.

About Us:

Christiana Care is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs.

We offer a comprehensive benefits package, including medical, dental, vision, life insurance, tuition assistance, and retirement planning offerings.

Our team is dedicated to providing exceptional patient care and making a positive impact in our community.

  • Nurse Case Manager

    5 days ago

    Dayton, Ohio, United States Professional Case Management Full time

    Make a Difference in Home HealthcareHiring Registered Nurses in Ohio for in-home healthcare services to support our nation's heroes.Why Our Team ThrivesCreate your own schedule for work-life balanceOne-on-one patient relationships in the comfort of their homesCompetitive benefit packages, including medical, dental, and vision benefitsHealth Savings &...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager, Physician Advisor,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager, Physician Advisor,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager, Physician Advisor,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services to our patients.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services to our patients.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services to our patients.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services to our patients.Job Summary:The Case Manager will work collaboratively with the Utilization Management team, Denial Manager,...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Shaker for ChristianaCare Direct Full time

    Job Title: Case ManagerWe are seeking a skilled Case Manager to join our team at Christiana Care Hospital. As a Case Manager, you will play a critical role in ensuring the delivery of efficient and effective healthcare services.Responsibilities:Collaborate with ED providers to review medical necessity and facilitate discharge planning.Ensure the delivery of...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Recovery Center of Ohio, LLC Full time

    Job SummaryWe are seeking a highly motivated and compassionate Case Manager to join our team at the Recovery Center of Ohio, LLC. As a Case Manager, you will play a vital role in helping individuals reclaim their lives from addiction and achieve long-term recovery.Key ResponsibilitiesMaintain a client caseload and provide regular support to ensure progress...

  • Case Manager

    2 weeks ago

    Dayton, Ohio, United States Maries House of Hope Full time

    Job Title: Case ManagerMaries House of Hope, Inc. is seeking a skilled Case Manager to join our team. As a Case Manager, you will play a critical role in developing and coordinating our program, working primarily with foster parents and adoptive families, and children in the independent living program.Job SummaryThe Case Manager will be responsible for...

  • Aeromedical Case Manager

    1 week ago

    Dayton, Ohio, United States Venesco Full time

    Aeromedical Case Manager Job DescriptionVenesco LLC is seeking a highly skilled Aeromedical Case Manager to support the 711th Human Performance Wing (711 HPW) at Wright-Patterson Air Force Base in Ohio.Responsibilities:Provide case management support and assistance to aid in mission accomplishment for the Aerospace Medicine Branch of the ACS.Review and track...

  • Case Manager

    1 day ago

    Dayton, Ohio, United States BayMark Health Services Full time

    Job Title: Full Time Case ManagerWe are seeking a highly skilled and compassionate Case Manager to join our team at BayMark Health Services. As a Case Manager, you will play a vital role in enhancing the overall treatment process by assisting therapists to meet the treatment needs of clients.Key Responsibilities:Act as a liaison between therapists, referral...

  • Case Manager

    4 days ago

    Dayton, Ohio, United States Armada Recovery Full time

    Case ManagerWe are seeking a dedicated and compassionate Case Manager to join our Substance Use Disorder (SUD) Clinic team at Armada Recovery. As a Case Manager, you will play a vital role in providing comprehensive support and assistance to individuals seeking treatment for substance use disorders in the community.Key Responsibilities:Assessment and...

  • Nurse Case Manager

    1 week ago

    Dayton, Ohio, United States Spectrum Healthcare Resources Full time

    Job Title: Registered Nurse-Case ManagerSpectrum Healthcare Resources is seeking a skilled Registered Nurse-Case Manager to support Wright Patterson Air Force Base in Dayton, OH.Job Summary:We are looking for a highly motivated and experienced Registered Nurse-Case Manager to join our team. The successful candidate will be responsible for providing nursing...

  • Nurse Case Manager

    2 weeks ago

    Dayton, Ohio, United States Spectrum Healthcare Resources Full time

    Job Title: Registered Nurse-Case ManagerSpectrum Healthcare Resources is seeking a skilled Registered Nurse-Case Manager to join our team at Wright Patterson Air Force Base in Dayton, OH.Job Summary:We are looking for a highly motivated and experienced Registered Nurse-Case Manager to provide exceptional care to our patients. As a Registered Nurse-Case...

  • Nurse Case Manager

    2 weeks ago

    Dayton, Ohio, United States Spectrum Healthcare Resources Full time

    Job Title: Registered Nurse-Case ManagerSpectrum Healthcare Resources is seeking a skilled Registered Nurse-Case Manager to support Wright Patterson Air Force Base in Dayton, OH.Job Requirements:Associate's Degree in Nursing (BSN preferred)4 years of experience in Disease Management (2 years for BSN graduates)Current, full, active, and unrestricted license...

  • Clinical Case Manager

    2 weeks ago

    Dayton, Ohio, United States Daybreak Full time

    Job Title: Clinical Case ManagerDaybreak is seeking a highly skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a critical role in providing comprehensive clinical case management services to youth and young adults in our Youth Homelessness Demonstration Project (YHDP) Rapid Rehousing (RRH) program.Key...

  • Nurse Case Manager

    3 weeks ago

    Dayton, Ohio, United States Spectrum Healthcare Resources Full time

    Job Title: Registered Nurse-Case ManagerSpectrum Healthcare Resources is seeking a skilled Registered Nurse-Case Manager to support Wright Patterson Air Force Base in Dayton, OH.Job Requirements:Associate's Degree in Nursing (BSN preferred)4 years of experience in Disease Management (2 years for BSN graduates)Current, full, active, and unrestricted license...

  • Case Manager

    4 weeks ago

    Dayton, Ohio, United States Akron House Recovery Full time

    Job SummaryWe are seeking a dedicated and compassionate Case Manager to join our Substance Use Disorder (SUD) Clinic team at Akron House Recovery. As a Case Manager, you will play a vital role in providing comprehensive support and assistance to individuals seeking treatment for substance use disorders in the community.Key ResponsibilitiesConduct thorough...