About the Organization
Phoenixville Hospital is a healthcare provider that offers leading-edge, compassionate healthcare and wellness services to its community. We provide a full range of medical care from prevention, screenings & education; to the latest clinical services and surgeries available; to rehabilitation. We also offer wellness programs & community health services that ensure our communities are the healthiest they can be. Our caring, highly trained physicians and staff are committed to patient safety and patient satisfaction.
The case manager is responsible to assist in the development, planning and coordination of patient flow in the hospital. Conduct initial and concurrent review of the medical record to determine appropriateness and medical necessity of admission, continued hospital stay and use of ancillary services.
- Interviews patients and families to assess for discharge needs.
- Screens for high risk patients and manages.
- Performs utilization function in accordance with InterQual standards, medicare regulations and payer contracts. This includes admission and concurrent reviews, seeking authorizations from payers as appropriate and referring cases to the Physician Adviser.
- Communicates determinations to all stakeholders.
- Utilizes Case Management software to document UM process as well as discharge process.
- Tracks avoidable days.
- Identifies barriers to treatment and can initiate a plan that supports optimal quality, cost and patient satisfaction.
- Current RN License in the state of PA
- RN from an accredited school of nursing
- Associate degree or Bachelor's Degree
- Certified Case Manager, preferred.
- 3 years Case Management experience, required
- 5 years RN experience, preferred.