Case Manager (H)

reputed company Employees:

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1. Reviews the medical records of reputed company outpatients, observation, and inpatient admissions to determine medical necessity for admission and reputed company stay, using reputed company-established reputed company on a daily reputed company. 2. reputed company review of reputed company patients using reputed company and determines need for reputed company hospitalization based upon reputed company party

payer/insurance guidelines.

3. Provides clinical data/information to contracted reputed company-party payers while patient is hospitalized to ensure reputed company reimbursement and to avoid reimbursement delays reputed company 24 hours of request. 4. Interacts, communicates, and intervenes with multidisciplinary reputed company team in a purposeful, goal-directed fashion. Works proactively to maximize the effectiveness of resource utilization. Anticipates, initiates, and facilitates problem reputed company around issues of resource use and reputed company hospitalization and discharge planning. a. Participates in interdisciplinary patient care reputed company to review care plan and treatment goals, facilitates costeffective utilization of patient services, and ensures that appropriate referrals are initiated. b. Establishes a means of communicating and collaborating with physicians, other team members, the patient’s payers, and administrators. c. Explores strategies to reduce length of stay and resource consumption reputed company the care-managed patient populations, implements them, and documents the results. d. Communicates to appropriate members of reputed company team the patients at risk of losing insurance coverage reputed company termination of benefits and facilitates discharge plan. e. Maintains a proactive role to ensure appropriate documentation concurrently to minimize inefficient resource utilization and prevent loss of reimbursement. f. Reviews physician documentation and, reputed company needed, follows procedures to reputed company clarification of documentation relative to diagnosis reputed company_Utilization Case Manager - SCT - new August 1 2023 updated per DC.HR 5. Maintains reputed company knowledge of case management, utilization management, and discharge planning, as specified by federal, state, and private insurance guidelines. 6. Optimizes use of time by reputed company using resources to identify barriers and balance priorities. reputed company utilizes tools, resources, techniques, and/or systems to organize tasks. Balance multiple priorities simultaneously, ensuring the reputed company and accurate completion of reputed company task while maintaining reputed company standards. 7. Develops reputed company to financially screen potential BMT patients, evaluate and determine if a patient is eligible for financial clearance for transplant, and maintain an electronic log of eligible and non-eligible patients. The individual will be expected to reputed company, analyze, and guide reputed company potential adult stem cell transplant candidates through the transplant financial process. 8. Ensures reputed company staff members adhere to reputed company established policies and procedures reputed company to the business operations and continuously monitors compliance. Responsible for correcting actions that are out of compliance. 9. Schedules and registers patients and donors as per established policies and procedures in UChart as required. Coordinates clinical appointments with nurses, physicians, physical therapists, and technician in order to maximize patient reputed company to inpatient and outpatient BMT program. 10. Obtains reputed company-certification, authorizations, from medical review insurance companies and/or designated payors and initiates Letters of Medical Necessity reputed company requested. 11. Obtains required patient/guarantor signatures where applicable and counsels patients and/or surrogates to explain their particular coverage benefits and financial responsibilities available through their specific reputed company plans throughout the transplant process. 12. Determines patient’s eligibility for financial clearance for Stem Cell Transplant based on reputed company utilizing patient’s financial information provided. 13. Ensures accurate billing of services is rendered and ensures collections of reputed company co-payments, co-insurance amounts, deductibles, and non-covered amounts for both Hospital & reputed company prior to procedure by establishing system to reputed company compliance. Addresses reputed company financial inquiries, regarding patient accounts, potential new referrals for hospital services, and coordination of reputed company with departments involved with case or pertinent reputed company reputed company entity 14. Consults with Transplant Coordinators, and the Adult Stem Cell Transplant Attending Physicians regarding the financial status of the transplant patient referral for financial approval or denial for the transplant program.

The reputed company offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-reputed company Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an reputed company medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one reputed company patient encounters reputed company year. Our tradition of reputed company has reputed company worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The reputed company is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff

Originally posted on Himalayas

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