Provides coordination of care in specific service area in such a manner as to use the right resources at the right time and as the right level of care. Utilizing collaborative process will assess patient needs, evaluates the options and services required to meet an individual's health needs and implements/facilitates plan. Serves as resource person and direct liaison between physician, hospital staff and in coordinating inpatient admissions of transfers from other acute care facilities and facilitates pre-admission insurance authorizations. Strong communication skills are necessary to access available resources, to communicate with 3rd party payers who authorize service and ensure quality and effective outcomes. Performs concurrent utilization review to ensure appropriate level of care and complete documentation. Reports to the Case Management Supervisor and the Director of Case Management.
Requires: CA RN license, and 1 year recent acute care hospital case management experience.