About
Graduate of an accredited school of nursing; BSN preferred
Licensure/Certification
Current, active Texas RN licensure required. Case Management certification preferred, but not required. BLS required.
Required Experience: Specific Job Experience
Minimum two (2) years acute care experience required. Previous case management experience preferred.
Principal Duties and Responsibilities:
The Case Manager works with all departments to insure appropriate patient care. Is able to work effectively with insurance co., Medicare etc. in making sure that we are paid appropriately for the patient care we give. Keeps the Business Office Manager, CNO and Clinical Services Director and Manager aware of any problems that have occurred in any area of patient care. Works with the Doctors and the Doctors' offices to ensure that we have the correct status for the patient and that the patient received the correct after care once home. Serves as a resource to Senior Management.
Knowledge, Skills and Abilities
Ability to work independently. Working knowledge of Microsoft Word and Excel preferred. Willingness to learn computer applications necessary for work functions. Ability to adapt to changing situations and various personalities with a positive attitude. Ability to utilize Electronic Heath Care Record for patient documentation. Adheres to strictest confidentiality in dealing with patients, families, hospital personnel and the public. Knowledge of professional nursing principles and CMS Conditions of Participation for Utilization Review Knowledge of current third-party regulations, Medicare, Medicaid benefits and services Knowledge of medical billing procedures
Languages
- English
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