Description

• Act as a liaison between Utilization Management and Case Management
• Implement the Case Management Referral Process 
  • Assess Case Management referrals in a timely manner
  • Obtains additiaonl information as needed to appropriately evaluate Case Management Services
  • Evaluates potential case management benefits to patient/family and customer
  • Identifies cases which would benefit from alternative levels of care and resources
  • Interfaces with payor of case management services or customer for case management approval and matters relevant to case management
  • Assigns cases to case manager based on current case load including case manager expertise, case severity, number of cases and client mix
• Understand Case Management concepts such as roles, philosophies, principals, liability and confidentiality issues and apply these concepts in developing initial case management plans and goals based on the needs of the patient
• Participate in AHH's committees and perform all assignments within the professional scope of the organization
• Comply with policies and procedures and conforms to URAC standards while performing job functions

Requirements

• Active, unrestricted license to practice nursing in the State of New York
• At least three years experience in an acute hospital setting or a minimum of five years experience in a speciality field, discharge planning/case management experience preferred
• Ability to interact with a wide variety of individuals and handle several complex situations simultaneously
• Evidence of creativity, integrity, and initiative
• Self-motivated
• Excellent verbal and written communication skills
• Attention to detail and follow up
• Proficient in use of Windows and Word

  To apply for this position, please submit your resume to humanresources@ahhinc.com.