This position functions as a Short Stay Case Manager for the Case Management Department under the direction of the Director of Case Management. The Short Stay Case Manager will incorporate the fundamental principles of utilization management, clinical appropriateness utilizing medical necessity criteria to assess the short stay admissions.. Manage the Medicare Short Stay review process, maintain tracking logs for all cases reviewed with clinical determination outcome and action taken to correct when warranted and conduct InterQual® reviews for admission when warranted. Ensure the appropriateness of patient admission is contained in the medical record. Report any inappropriate admission cases to the Director and/or Operations Manager as often as necessary. Proactively collaborate with physicians(s) to assist in education of appropriate level of care for patients.
A minimum of (2) two years in Hospital Case Management; a good working knowledge of patient assessment, medical terminology and Interqual criteria®. A good working knowledge of patient assessment. In-depth knowledge of medical terminology.In-depth knowledge related to signs and symptoms and appropriate treatments for medical/surgical diagnosis. Current Florida RN license, RRT or Degree as a Foreign Medical Doctor/Graduate may be considered depending on background and prior experience and CPR certification Any combination of relevant education, work experience, and / or certifications will be considered.