Care Manager

Location: WK Medical Center
Department: Care Management
Classification: Full-Time
Shift: 7:30 AM-4:00 PM
Date Posted: 6/19/2019
Description: UTILIZATION REVIEW POSITION

This employee will work with the Case Managers to ensure that the hospital renders quality care in a cost effective manner within the reimbursement guidelines.  This employee is responsible for providing plans of care, orders, a summary, and extended stay reviews to Medicare, Medicaid, and private insurance companies requesting this on their insured patients. 
 
The Utilization Management Program promotes the appropriate allocation of hospital’s resources and quality care for each patient based upon each patient's identified needs and involvement in their care decisions.
 
In the position, the goal is to assure that concurrent reviews are continuously performed and documented in a proper and timely manner and to promote the efficient utilization of beds and services through concurrent and retrospective reviews of the necessity for inpatient admission, appropriate status, appropriate length of stay, and timely and appropriate use of diagnostic and therapeutic services.
 
The employee will assure that the medical record substantiates through clear documentation the quality and utilization of services needed for the management and progress of each patient, and must assess and improve the delivery of quality care to all patients, regardless of payment source, in an efficient and cost-effective manner.
 

QUALIFICATIONS:

Valid Louisiana nursing license (RN) preferred

2 to 3 years clinical experience in an acute care setting.  Utilization and/or Case Management experience desirable.

HOURS - 7:30a-4p

Willis-Knighton is an equal opportunity employer and thus, manages its employment and employee relations policies, practices and benefits without regard to age, race, sex, color, creed, religion, national origin, disability, veteran, or other protected status where otherwise qualified.