Case Manager II / PRN
St. Elizabeth's Hospital - Belleville, IL

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Job Details:
- Licensure Required
- Experience is required
Position: Care Cordination c oordinates the care/service of selected patients to promote effective utilization of health care resources and interacts with the interdisciplinary team for achievement of optimal clinical & resource outcomes. Concurrently reviews the medical record and queries medical staff and other caregivers as necessary to obtain accurate and complete documentation that supports the patient’s severity of illness. Screens patient records for appropriate utilization of medical services and quality medical management. Provides information to third-party payers and/or regulatory agencies as requested to meet provider guidelines for reimbursement. Assists with patient discharge planning including screening for post-discharge needs and assisting with Home Health, DME, and other services needed to facilitate a safe and timely discharge.

Requirements:

  • RN with current Illinois license
  • 3 - 5 years clinical experience
  • Basic computer word processing knowledge and proficiency

  • Preferences:

  • Prior experience in Utilization Review and Quality Assurance

  • Working knowledge of Medicare reimbursement and coding strucutures

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