As a Case Manager you will monitor, evaluate and assist in the maintenance and improvement of efficient utilization of hospital resources through performance of pre-admission/admission and continued stay medical record reviews. Intervene to reduce and eliminate service delays and non-acute hospital days. Become a member of an excellent team that heals people, promotes health and strengthens communities.
We are looking for someone that shares our same core values of; compassion, accountability, collaboration, foresight, and joy.
IDEAL CANDIDATE - Successful completion of Quality or Utilization Review certification examination desired.
- Active membership in professional organizations (i.e., NAHQ, WAHO) beneficial.
- Certification in Case Management desired.
- Possesses general understanding and knowledge of:
- Medicare system
- MedStar initiatives
- Utilization review principles and objectives
- Managed care indicators
- Quality Improvement principles and Risk Management objectives
- Possesses and exercises good public relations skills.
- Possesses strong clinical skills, assessment and good professional judgment, as well as broad-based knowledge of medical management, nursing management and medical terminology.
- Demonstrates the ability to read and comprehend government regulations and contracts.
- Demonstrates familiarity and knowledge of medical records organization and procedures.
REQUIREMENTS - Possesses an active Wisconsin RN nursing license.
- Bachelor's Degree in Nursing preferred.
- Minimum of one year of Case Management experience.
- Minimum of two years' acute care hospital experience.
- Experience in critical care, general medical and/or surgical nursing, and experience in educational presentations beneficial, as well as previous experience in the application of Utilization Review activities and medical record reviews.
