Case Manager-PRN

Full Time
Tipton, IN 46072
Posted
Job description

Overview

Indiana University Health is seeking a Case Manager-PRN to join the team!

A Case Manager-PRN plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely and effective discharge planning for patients. Works with third party payers to ensure coverage. Administers education and prevention programs.

  • Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.
  • Requires current state of Indiana license as a Registered Nurse.
  • Certification in Case Management preferred.
  • Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
  • Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
  • Ability to comprehend third party contractual arrangements is preferred.
  • Understanding of the third party denial and appeal process is preferred.
  • Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
  • 3-5 years of experience required.
  • Requires strong clinical background in acute care.

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