Job Description & Requirements
Registered Nurse – Case Management- Case Manager
Casemanager will review demographic and clinical information of the patient to determine medical necessity for surgical intervention. Provide hospital case management/utilization review and discharge plan to assure that the patient progresses through the continuum of care and is discharged in a timely manner to the most appropriate environment. Determine that patient has met criteria for admission for neurosurgical and orthopaedic procedures and ensure pre-authorization has been obtained from payor. Ensure clinical documentation supports continued hospitalization and communicates with physicians regarding readiness for discharge. Maintains competency with the electronic health record for documentation/support of medical necessity purposes