patient financial services manager

Community Health of South Florida

<p><b>POSITION PURPOSE:</b><br>
<br>
The purpose of the Patient Financial Services Specialist is to ensure that the Billing and Encounter Forms are processed correctly. Coordination of work from the patient care areas, maintaining the work flow of documents to and from Data Processing.<br>
<br>
<b>POSITION REQUIREMENTS / QUALIFICATIONS:</b><br>
<br>
<b>Education/Experience</b>:
<br>
A minimum of High School Diploma or GED Equivalent. ICD 9 Coding experience preferred. Experience with Patient Services. Must have knowledge of Medicaid / Medicare Insurance, collection and setup.<br>
<br>
<b>Licensure / Certification:</b>
<br>
Maintain current CPR certification from the American Heart Association.<br>
<br>
<b>Skills / Ability</b>:
<br>
Ability to work as a team member. Must have clerical skills, ability to type 20 - 30 wpm and have interviewing skills. Must have knowledge of math, operation of calculator; telephone etiquette, human relation skills and organizational skills. Must be computer literate. Ability to demonstrate effective oral and written communication skills.<br>
<br>
<b>POSITION RESPONSIBILITIES (THIS IS A NON-EXEMPT POSITION)</b><br>
<br>
Register new client on Intergy as per guidelines issued by Community Health of So. Florida.<br>
<br>
Researches files for previous enrollment in CHI computer system before creating a new medical record number.<br>
<br>
Re-new or update existing clients profiles as per guidelines issued by Community Health of South Florida.<br>
<br>
Performs financial screening on active clients who have requested services from Community Health of South Florida, Inc.<br>
<br>
Attempt collection o Completes assigned task in a timely manner.f past due debts as clients request services from CHI.<br>
<br>
Check-in clients for needed medical services.<br>
<br>
Check-out clients upon receiving medical services.<br>
<br>
Process of patient payments.<br>
<br>
Review and balance out daily batches.<br>
<br>
Submit daily journal to assigned supervisor.<br>
<br>
Submit cash and copies of daily batches to the Accounting Department for deposit.<br>
<br>
Complete statistical data and submit daily.<br>
<br>
Reviews Quality Care Guidelines/Patient Reminder print-out to identify overdue items e.g. Advance Directives, Learning Needs Assessment, Depression Screening, etc.<br>
<br>
Identifies patients who have not executed an Advance Directive and provide them with the Advance Directive form to read.<br>
<br>
Identifies patients who need a Learning Needs Assessment and gives them the form to complete.<br>
<br>
Identifies patients due for Depression Screening and provide them with a PHQ-9 form in the appropriate language to complete.<br>
<br>
Gives all new patients a New Patient History form to complete before Nursing Staff calls the patient.<br>
<br>
Attaches a completed new patient lab request form to the encounter form of every new patient.<br>
<br>
Consistently informs patients that their Provider wants them to read or complete the appropriate forms or education material while waiting to see the Provider.<br>
<br>
Verifies Medicare, Medicaid and all other insurance carriers.<br>
<br>
Performs daily balance closing and ensures that all procedures and payments are posted accurately.<br>
<br>
Performs cashier duties, collect patient funds for services and enters data into computer for payment received.<br>
<br>
Train new employees on all functions of Patient Services (i.e. registration, cashiering, posting of B&amp;E&rsquo;s and Payments).<br>
<br>
Use appropriate and correct telephone etiquette at all times.<br>
<br>
Participates in Continuing Educational In-services and Performance Improvement Activities.<br>
<br>
Reports to work on time and ready to work with minimal absenteeism.<br>
<br>
Completes &amp; Post all B&amp;E (billing and encounter) forms within the same of service.<br>
<br>
Adheres to the Confidentiality Policies and Procedures / HIPAA Regulations.<br>
<br>
Performs other duties as assigned, including variable shifts if needed.</p>

PATIENT FINANCIAL SERVICES SPECIALIST

Jarrell Family Dentistry

<div>Company:
<div></div>
Overview:
<h2 class="jobSectionHeader"><b>Dental Office Manager &ndash; Job Description</b></h2><p><b>
Job Title:</b> Dental Office Manager</p><p><b>
Location: </b>Jarrell, Texas<br>
<b>Employment Type:</b> Full-Time</p><h3 class="jobSectionHeader"><b>
Job Summary</b></h3><p>
The Dental Office Manager is responsible for overseeing the daily administrative operations of the dental practice. This role ensures efficient office workflow, excellent patient experience, proper staff coordination, and financial performance of the practice. The Office Manager serves as the primary point of contact for administrative staff and supports clinical staff to ensure smooth practice operations.</p><h3 class="jobSectionHeader"><b>
Key Responsibilities</b></h3><p><b>
Office Operations</b></p><ul><li><p>
Manage daily operations of the dental office to ensure efficiency and organization.</p></li><li><p>
Oversee appointment scheduling, patient flow, and front desk operations.</p></li><li><p>
Maintain office policies and procedures.</p></li><li><p>
Ensure compliance with HIPAA, OSHA, and other regulatory requirements.</p></li></ul><p><b>
Staff Management</b></p><ul><li><p>
Supervise and support front office staff and administrative team.</p></li><li><p>
Coordinate hiring, onboarding, training, and performance evaluations.</p></li><li><p>
Create and manage staff schedules and coverage.</p></li><li><p>
Foster a positive, professional work environment.</p></li></ul><p><b>
Patient Relations</b></p><ul><li><p>
Ensure high levels of patient satisfaction and customer service.</p></li><li><p>
Handle patient concerns, complaints, and escalations professionally.</p></li><li><p>
Monitor patient communication including calls, emails, and reminders.</p></li></ul><p><b>
Financial Management</b></p><ul><li><p>
Oversee billing, insurance verification, and claims processing.</p></li><li><p>
Monitor accounts receivable and collections.</p></li><li><p>
Manage office budgets, financial reporting, and supply costs.</p></li><li><p>
Coordinate with insurance companies and ensure accurate patient billing.</p></li></ul><p><b>
Administrative Duties</b></p><ul><li><p>
Maintain patient records and office documentation.</p></li><li><p>
Manage vendor relationships and order office supplies.</p></li><li><p>
Track productivity metrics and prepare operational reports.</p></li><li><p>
Implement systems to improve office efficiency and profitability.</p></li></ul><h3 class="jobSectionHeader"><b>
Qualifications</b></h3><ul><li><p>
High school diploma or equivalent required; Associate or Bachelor&rsquo;s degree preferred.</p></li><li><p>
2&ndash;5 years of experience in dental office management or healthcare administration.</p></li><li><p>
Knowledge of dental practice management software.</p></li><li><p>
Understanding of dental insurance, billing, and coding procedures.</p></li><li><p>
Strong leadership, organizational, and communication skills.</p></li></ul><h3 class="jobSectionHeader"><b>
Skills &amp; Competencies</b></h3><ul><li><p>
Leadership and team management</p></li><li><p>
Patient service and conflict resolution</p></li><li><p>
Financial and billing knowledge</p></li><li><p>
Multitasking and time management</p></li><li><p>
Attention to detail</p></li><li><p>
Problem-solving and decision-making</p></li></ul><h3 class="jobSectionHeader"><b>
Work Environment</b></h3><ul><li><p>
Fast-paced dental office setting</p></li><li><p>
Primarily desk and administrative work with occasional interaction with clinical staff and patients</p></li><li><p>
Standard office hours with occasional extended hours if needed</p></li></ul><h3 class="jobSectionHeader"><b>
Benefits</b></h3><ul><li><p>
Health, dental, and vision insurance</p></li><li><p>
Paid time off</p></li><li><p>
Retirement plan</p></li><li><p>
Continuing education opportunities</p></li><li><p>
Employee discounts on dental services</p></li></ul>
Essential Functions:<br>
<div></div>
Additional Eligibility Qualifications:<br>
<div></div>
Pay Range: USD $35.00 - USD $40.00 /Hr.</div>

Office Manager

Lifepoint Health

<div><p><b>Facility Name: </b>Charlton Memorial Hospital</p><p><b>
Job Title: </b>Case Manager (Licensed)</p><div><b>
Job Type: </b>Fulltime, Exempt</div><div><b>
Schedule:</b> Days</div><div></div><div><b><br>
Your experience matters</b></div><div>
Lifepoint Rehabilitation is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a <b>Case Manager</b> joining our team, you&rsquo;re embracing a vital mission dedicated to <i>making communities healthier</i><i> &reg;</i>. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.</div><div></div><div><b><br>
More about our team</b></div><div>
Charlton Memorial Hospital provides a full range of inpatient services and out of all the hospitals in the Fall River area we have provided continuous service to our community since 1885. In addition to inpatient services, we provide a comprehensive mix of rehabilitative services and outpatient therapies. When you choose Charlton Memorial Hospital, you&rsquo;ll receive attention, support, and care every step of the way.</div><div></div><div><b><br>
How you&rsquo;ll contribute</b></div><div>
The <b>Licensed Case Manager</b> in an Inpatient Rehabilitation Unit is responsible for coordinating patient care to ensure optimal outcomes, efficient resource utilization, and compliance with regulatory and payer requirements. This role conducts comprehensive assessments, develops and implements individualized care plans, and collaborates with an interdisciplinary team to support patient progress and discharge planning. Serving as a patient advocate, the Case Manager facilitates continuity of care by coordinating services, addressing barriers, and aligning treatment goals with patient preferences. The position also integrates case management, utilization review, and discharge planning functions while maintaining accurate documentation and promoting high-quality, cost-effective, patient-centered care.</div><div></div><div><b><br>
Why join us</b></div><p>
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:</p><ul><li><p><b>
Comprehensive Benefits</b>: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.</p></li><li><p><b>
Financial Protection &amp; PTO</b>: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.</p></li><li><p><b>
Financial &amp; Career Growth</b>: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.</p></li><li><p><b>
Employee Well-being</b>: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).</p></li><li><p><b>
Professional Development</b>: Ongoing learning and career advancement opportunities.</p></li></ul><p></p><div><b><br>
What we&rsquo;re looking for</b></div><p>
Applicants should have</p><ul><li><p>
Clinical degree and current license to practice as an OT, PT, RN, SLP, or LMSW</p></li><li><div>
Certification in Case Management or Rehabilitation Nursing preferred</div><ul><li><div>
Commission for Case Manager Certification (CCM), Association of Rehabilitation Nurses (ARN) certification, American Case Management Association (ACM) or Board Certification in CM by the ANCC e.g.: RN-BC</div></li></ul></li><li><div>
Minimum of two (2) years social work or case management experience in an inpatient setting highly preferred</div><ul><li><div>
acute/rehabilitation hospital experience preferred</div></li></ul></li><li><div>
Effective oral and written communication skills in English, additional languages preferred</div></li></ul><div><b><br>
Connect with our Recruiter</b><br>
Not ready to complete an application, or have questions? Please contact Brandi Walton, Talent Acquisition Recruiter at 629-257-6103, brandi.walton1@lifepointhealth.net. Or Click Here to schedule a time to discuss your career interests with Lifepoint Health!</div><div></div><div><br>
Hourly range: $40 - $48 per hour</div><div></div><div><b><br>
EEOC Statement</b></div><div>
&ldquo;Lifepoint Rehabilitation is an Equal Opportunity Employer. Lifepoint Rehabilitation is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.&rdquo;</div>
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.</div>

Case Manager (CM)

BSA Outpatient Therapy Services

<div>Overview:
<div>
Join our team as a day shift, full-time, Outpatient Therapy Services Case Manager Social Worker in Amarillo, TX.</div><div></div><div><b><br>
Why Join Us?</b></div><div></div><div><b><br>
Thrive in a People-First Environment and Make Healthcare Better</b></div><ul><li><i>
Thrive:</i> We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being.</li><li><i>
People-First:</i> We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for.</li><li><i>
Make Healthcare Better:</i> We use advanced technology to support our team and enhance patient care.</li></ul><div><b>
Get to Know Your Team:</b></div><ul><li>
BSA Hospital is a 445-bed hospital serving the Amarillo area for over 120 years and continues to be Amarillo&rsquo;s preferred healthcare provider. At BSA, the focus is to provide quality healthcare in Christian love, service and dignity.</li></ul>
Responsibilities:
<ul><li>The Case Manager assesses the social, psychological, cultural, environmental and financial situations concerning the patient and family.</li><li>
He/she is a patient/family advocate, promoting rights and dignity and striving to involve the patient/family in aspects of care as appropriate.</li><li>
The Case Manager also facilitates the acute, rehabilitative, and long-term discharge processes to provide for an optimal age-specific continuum of care for the populations listed below.</li><li>
Accountable for the care of patients assigned to them in accordance with the Nurse Practice Act and Policies and Procedures of BSA.</li></ul>
Qualifications:
<div>
Job Requirements:</div><ul><li>
Bachelor&rsquo;s Degree in Social Work.</li><li>
Must be licensed BSW or LMSW within 6 months of hire or transfer into position</li></ul><div>
Preferred Job Requirements:</div><ul><li><div>
2+ years&rsquo; social work experience in any setting.</div></li><li><div>
Experience in acute care hospital case management.</div></li><li><div>
Certification in case management (ACM or CCM).</div></li></ul></div>

Case Manager / Social Worker OTS Spine Center

The University of Kansas Health System

<div><div><div><div><div><div><div><div><h1 class="jobSectionHeader"><b>Position Title
</b></h1></div></div></div></div></div></div></div><p></p>PRN Behavioral Health Case Manager
<p></p>Strawberry Hill Campus
<p></p><h2 class="jobSectionHeader"><b>Position Summary / Career Interest:
</b></h2>The Behavioral Health Case Manager is responsible to provide care/service safely and efficiently for a full range of services to patients of all ages and their families. Primary role is to collaborate, communicate and facilitate coordination of services during and post-hospitalization as established by the behavioral health care team and executed by the case manager.
<p></p><p><b>Responsibilities and Essential Job Functions
</b></p><ul><li>Must be able to perform the professional, clinical and/or technical competencies of the assigned unit or department.
</li><li>Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice. Follows policies, procedures, and standards. Assumes responsibility for risk and safety issues associated with the position. Takes call as required by the department expectations. Performs job specific responsibilities and demonstrates accountability for own actions and decisions.
</li><li>Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope. Brings ideas and concerns to supervisor, participates in department decision making. Maintains current licensure.
</li><li>Initiates and participates in family conferences to determine psychosocial and discharge planning needs.
</li><li>Completes psychosocial assessments of patient/family situations including social, psychological, emotional, financial and other related factors to facilitate patients return to the community.
</li><li>Utilizes social work assessment and input from other team members to formulate realistic recommendations for social work action plan while patient is hospitalized and formulate and execute an appropriate discharge plan.
</li><li>Locates community resources and connects patient with resources to assist in their living situation
</li><li>Assists in determining financial concerns including insurance and assists in application for social security benefits (such as SSD, SSI or any other applicable social security benefits) as well as application for Medicaid/Medicare if appropriate.
</li><li>Responsible for understanding various State Waivers, qualifications for each waiver and how to assist patients in determining eligibility and obtainment of waiver services.
</li><li>Connects patient with Community Mental Health or other agencies or private providers to provide:Psychiatry follow-up appointments
</li><li>Psychotherapy and Expressive Arts therapy appointments,
</li><li>Intensive Case Management (Outpatient)
</li><li>Other social services such as substance abuse treatment, support groups (various subjects), etc.
</li><li>Coordinates community placement for appropriate post-hospital discharge planning and coordination if patient needs a community placement such as a group home, sober living arrangement, Mental Health Nursing Home or other placement that would be deemed most appropriate to the patient&rsquo;s needs and safety.
</li><li>Advocates on behalf of patients and caregivers for identification and access to services. Advocates for the protection of the patient's health, safety and rights. Ensures patient choice and consistently supports a patient centered environment.
</li><li>Documents appropriate information in the patient&rsquo;s medical record to ensure communication of patients&rsquo; psychosocial needs during inpatient stay and post discharge care
</li><li>Documentation includes initial contact note
</li><li>Documentation includes psychosocial assessment of patient/family including previous living situations.
</li><li>Documentation includes daily telephone calls and meetings with significant others and allied professionals.
</li><li>Documentation includes all family and/or discharge planning conferences.
</li><li>Documentation of all patient encounters shall be completed within 24 hours of the date of service.Contributes to the financial viability of hospitals.
</li><li>Works in partnership with the treatment team to ensure timely patient discharge.
</li><li>Utilizes established procedures and appropriate resources in working with third party payors to ensure safe and timely discharge.
</li><li>Participates in the case management activities at assigned site/service.
</li><li>Demonstrates flexibility and teamwork among case management staff members.
</li><li>Assists peers in the event of fluctuating census.
</li><li>Provides coverage to other services as needed or as requested by Manager
</li><li>Participates in interdisciplinary team meetings as needed
</li><li>Other duties as assigned by Clinical Manager.
</li><li>Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
</li>These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.<br>
<li>
</li></ul><p><br>
<b>Required Education and Experience
</b></p>Master's Degree<br>
<ul><li>
</li></ul><p><br>
<b>Required Licensure and Certification
</b></p><ul><li>Master&rsquo;s level Licensure with the Behavioral Sciences Regulatory Board as one of the following:
<br>
Licensed Professional Counselor (KS)
<br>
Licensed Master Social Worker (KS)
<br>
Licensed Marriage and Family Therapist (KS)
</li>State of Kansas Social Work license<br>
<li>
</li></ul><p><br>
<b>Knowledge Requirements
</b></p><ul><li>Ability to proficiently read and document in electronic medical record required.
</li></ul><p></p><h2 class="jobSectionHeader"><b>Time Type:
</b></h2>Part time
<p></p><h2 class="jobSectionHeader"><b>Job Requisition ID:
</b></h2>R-51434
<p></p><h3 class="jobSectionHeader"><b>Important information for you to know as you apply:
</b></h3><ul><li><p>The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. <i>See also </i>Diversity, Equity &amp; Inclusion <i>.
</i></p></li><li><p>The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu .
</p></li><li><p>Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.
</p></li></ul><p></p><h2 class="jobSectionHeader"><b>Need help finding the right job?
</b></h2><p></p><p>We can recommend jobs specifically for you! Create a custom Job Alert by selecting criteria that suit your career interests.</p></div>

PRN Behavioral Health Case Manager

Orlando Health

<div>Position Summary:
<div><b>
Department:</b><b> </b>Orlando Health Ambulatory - Outpatient Rehab</div><div><b>
Status:</b> Full-Time | 40 hours per week</div><div><b>
Shift:</b> Monday - Friday, 8am - 5pm</div><div><b>
Title:</b>Ancillary Scheudling, Registration, and Patient Charge Specialist</div><div></div><div><b><br>
***Address of Practice: 1222 S. Orange Ave 5th floor Orlando, Fl 32806***</b></div><div></div><div><b><br>
Position Summary</b></div><div>
This position is for our downtown outpatient orthopedic and sports rehab clinic located in the Orlando Health Heart Institute. Responsibilities include patient check in/out, registration, insurance verification/authorization, scheduling, and front office operations.</div><div><br>
</div><div><b>All Inclusive Benefits (start day one)</b></div><div>
Health/Dental/Vision/Life Insurance, Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.</div>
Responsibilities:
<div><b>
Essential Functions</b></div><ul><li>Effective pre-registration, registration and scheduling of multiple patient appointments.</li><li>Manages the multiple additions and cancellations of patient appointments.</li><li>Efficiently and accurately gathers and inputs patient/guarantor demographic and financial information in appropriate hospital</li></ul>
systems
<br>
<ul><li>Contacts appropriate payers/provider offices, verifying benefits and obtaining/documenting necessary authorizations.
</li><li>Consistently and constantly reviews the schedules daily and communicates all changes to appropriate staff.</li><li>Responsible for entry of patient charges.</li><li>Acts as a liaison between the provider and patient to explain insurance benefits, co-pays, deductibles, and self pay portions.</li><li>Accurately communicates all procedure pertinent information including arrival time, location, and duration to the patient.
</li><li>Performs check in and check out of patients.</li><li>Acts as a liaison to the clinical staff.
</li><li>Acts as a liaison to the clinical and business staff to ensure effective and efficient patient management including the transfer of
</li></ul>patients from both outside and sister facilities.<br>
<ul><li>Acts as a resource for training or mentoring of new team members.</li><li>Maintains flexibility in work schedule availability that allows department to change/modify work schedule to meet departmental
</li></ul>needs and on call responsibilities.
<br>
<ul><li>Attends and participates in department staff meetings and attends other meetings as assigned.</li><li>Represents and participates in department, facility, Patient Financial Services and corporate committees as requested by
</li></ul>supervisor/department manager.<br>
<ul><li>Responsible for reviewing and adhering to all corporate departmental and education initiatives.</li><li>Assists his/her supervisor/manager in planning and organizing department activities.</li><li>Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state
</li></ul>and local standards.<br>
<ul><li>Maintains compliance with all Orlando Health policies and procedures.</li></ul>
Qualifications:
<div><b>
Education/Training</b></div><div>
Must be able to demonstrate reading, verbal and written communication, mathematical, and reasoning skills typically acquired
<br>
through completion of a high school education.</div><div><br>
<br>
<b>Licensure/Certification</b><br>
None.</div><div><b><br>
Experience</b><br>
Two (2) years&rsquo; experience in financial, business office, or customer service environment required. Computer knowledge necessary.</div></div>

Ancillary Scheduler - OHHVI Rehab Clinic

Gila River Health Care

<div><p><b>Summary </b>:
</p><p>The Case Manager will provide comprehensive Case Management for patients as assigned to include, but not limited to: assessing patient&rsquo;s needs; developing, implementing, monitoring, and documenting the progress of the patient throughout their hospitalization in an outside area hospital to meet their care needs prior to discharge. The intensity of Case Management is situational and appropriately based on patient need. This position is accountable for the quality of clinical services provided by both them and others and identifies barriers which may hinder effective patient care. The Case Manager performs Utilization Review of the medical necessity and appropriateness of care using InterQual criteria of patients admitted to Gila River Health Care inpatient unit: assessing patient admissions and continued stay criteria to identify issues that may delay patient discharge and facilitate resolution of these issues.<br>
<br>
</p><p><b>Critical Tasks:
</b></p><p></p><ul><li>Demonstrates a culture of kindness through all interactions whether verbal or non-verbal with all GRHC staff members, partner facilities staff and vendors.
</li></ul><ul><li>Manages and oversees assigned patient case load to ensure delivery of all covered services identified for continuity of care across all levels of care and involved providers to achieve the optimal clinical, financial, operational, and patient satisfaction outcomes.
</li></ul><ul><li>Maintains HIPAA standards of patient confidentiality during all interactions whether written, verbal, or electronic.
</li></ul><ul><li>Establishes and promotes a collaborative relationship with members of the healthcare team within GRHC and outside facility partners.
</li></ul><ul><li>Serves as Case Manager between referral hospitals, treatment facilities and patients/patient&rsquo;s families to ensure delivery of effective and appropriate assistance and follow-up for returning to pre/post hospitalization status/care.
</li></ul><ul><li>Reviews charts of assigned patients to determine appropriate referral services based on assessed patient needs.
</li></ul><ul><li>Facilitates, schedules and/or participates in a variety of patient Case Management activities to ensure patient and/or family personal and health care needs are met in a timely manner; proactively identifies alternative resources as needed.
</li></ul><ul><li>Participates in &ldquo;on-call&rdquo; for Case Management Department and Utilization Review
</li></ul><ul><li>Performs Utilization Review of patient chart to ensure compliance with established InterQual criteria to maximize reimbursement/coverage of charges.
</li></ul><ul><li>Evaluates inpatient medical necessity and appropriateness of care utilizing InterQual criteria, for optimizing outcomes.
</li></ul><ul><li>Assesses patient admissions and continued stay to identify issues that may delay patient discharge and communicates to the interdisciplinary team while facilitating a resolution.
</li></ul><ul><li>Collects and communicates pertinent, timely information to the health care team to fulfill utilization and regulatory requirements.
</li></ul><ul><li>Collaborates with patient, family members, and other involved parties to ensure care coverage through private and governmental health care plans.
</li></ul><ul><li>Collects outcome data to be used in identifying best practices and targeting performance improvement solutions.
</li></ul><ul><li>Participates in departmental orientation, on the job training, and quality assurance programs/initiatives.
</li></ul><ul><li>Receives and responds to patient concerns; research issues for corrective action as appropriate based on findings; escalates physician/provider concerns to appropriate parties and identifies alternative solutions.
</li></ul><ul><li>Participates in a variety of department and hospital educational programs to maintain current skill and competency levels; identifies and discusses performance or training needs with Supervisor.
</li></ul><ul><li>Participates in Community Events representing GRHC and Case Management Department with ability to educate on departmental functions.
</li></ul><ul><li>Other duties as assigned by Case Management Director/Manager
</li></ul><ul><li>Establishes goals and objectives for the department that meet or exceed GRHC&rsquo;s Code of Ethics and Standards for Conduct Policy.
</li></ul><ul><li>Is familiar and remains current on safety and emergency management process for the department.
</li></ul><p><b>Required Qualifications:
</b></p><ul><li>Current State of Arizona or Compact State Registered Nurse license, BSN preferred.
</li></ul><ul><li>Current CPR for Healthcare professional's certification
</li></ul><ul><li>Must have at least 1-year previous case management experience, CCM certification preferred but must obtain within 2 years of hire.
</li></ul><ul><li>Experience must include working in an acute care and/or home care setting for at least a 12-month period.
</li></ul><ul><li>Native American population preferred.
</li></ul><ul><li>Must have a working knowledge of Case Management, acute care and/or home care environments, community resources and resource/utilization management.
</li></ul><ul><li><b><i>Case Management Specialty Area Requirements </i></b>:
<ul><li><i>Pediatrics Case Manager &ndash; Must have at least 1 year Pediatrics experience
</i></li><li><i>Cancer Case Manager &ndash; Must have at least 1 year oncology/hospice/or cancer case management experience
</i></li><li><i>Pain Management Case Manager &ndash; Must have at least 1 year experience working with pain management patients/hospice patients </i><i>.
</i></li><li><i>Women&rsquo;s Health/High Risk Pregnancy Case Manager &ndash; Must have at least 1 year Women&rsquo;s Health/Pregnancy experience
</i></li><li><i>Family Medicine Case Manager &ndash; Must have at least 1 year Medical-Surgical or Family Clinic experience
</i></li><li><i>Internal Medicine Case Manager - Must have at least 1 year Medical-Surgical or Family Clinic experience
</i></li><li><i>Emergency Department/Utilization Review Case Manager &ndash; Must have 1 year Medical-Surgical experience and/or 1 year Utilization Review experience</i></li></ul></li></ul></div>

Case Manager-Case Management-HHK-Sacaton

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