CASE MANAGER FT - Utilization Review (13993)
CULLMAN REGIONAL · Cullman Regional Medical Center - Cullman, AL 35056
Job Summary:
- Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost-effective care.
- Support physician provision of patient care with accountability for designated patient case load.
- Facilitate precertification and payor authorization processes and facilitate collaborative management of patient care across the continuum, intervening as necessary.
- Promote effective utilization and monitoring of healthcare resources and assumes a leadership role with the multidisciplinary team to achieve optimal clinical and resource outcomes.
- Apply process improvement methodologies in evaluating outcomes of care.
- Maintain and ensure adherence to clinical guidelines, tools and protocols based on evidence-based medicine related to quality measure indicators.
- Assume leadership role in coordinating quality improvement activities related to quality measure initiatives.
- Demonstrate and encourage team behavior and exceptional patient/guest experiences.
- Uphold and promote patient safety and quality.