Managed Care Case Manager - Pikeville KY - Vitus Search Group : Job Details

Vitus Search Group has recently partnered with a massive Managed Care provider that services the 48 states We are seeking Case Managers in multiple areas around the country A great job for a RN - Registered Nurse Full job description JOB RESPONSIBILITIES: Provide on-site (hospital, skilled nursing facility) and/or telephonic inpatient case management and concurrent review for identified hospitalized members. Monitor medical necessity, appropriateness and efficiency of care using established inpatient guidelines, contacting Supervisor, Physician, Specialist, Hospitalist, and Medical Director as needed. Coordinating and assisting with discharging patients from hospitals and SNFs. Coordinating transfer of patient to in network facilities when appropriate. Participate in discussion of delays / barriers / progression of care at care coordination rounds or in 1:1 meetings with physicians, specialists and/or hospital staff. Be knowledgeable of patients available benefits / coverage / payor i...Case Manager, Manager, Medical Director, Healthcare, Staffing, Patient, Hospital