Case Manager
Botsford Hospital - Farmington Hills, MI

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Reviews, assesses, monitors and assists in the evaluation of a patient’s hospitalization utilizing complex decision making resources in accordance with the following: pre-established criteria; appropriate clinical pathways; medical record; external managed care regulations; expert multidisciplinary collaboration; state and federal utilization management requirements; department and hospital policies and procedures. Identifies delays in patient service, treatment and/or discharge and intervenes to facilitate timely patient care services and treatment. Coordinates select continuing care services for patients (i.e. home health care, durable medical equipment, or extended care facility). Promotes hospital reimbursement by coordination of external managed care pre-certification programs and clinical appeal process. Utilizes case management computer system (i.e. Maxsys II). A. Minimum Education: A level of knowledge normally acquired through completion of a Bachelor's of Science Degree in Nursing from an accredited school. B. Minimum Work Experience: Two to four years of clinical experience. Minimum of one to two years discharge planning, community health nursing or utilization management. C. Certification, Licensure, Registration: Current license to practice as a Registered Nurse in the State of Michigan.


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