Top 10 Case manager Jobs in Pink Hill, Nc

Case Manager
UNC Health —Kinston, NC
- Per diem
- Nursing
- RN License
- Hospital
Residential Case Manager
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- Microsoft Excel
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Home Health Registered Nurse Case Manager
Centerwell —Pink Hill, NC
- $77,200 - $106,200 a year
- Full-time
- CPR Certification
- Medication administration
- RN License
- Paid parental leave
- Paid holidays
Case Manager, RN or Social Worker (BSW)
UNC Health —Kinston, NC
- $32.48 - $38.98 an hour
- Full-time
- Nursing
- RN License
- Hospital

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Case Manager

UNC Health -
Kinston, NC

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Job Details

Per diem

Qualifications

Appeals
Nursing
Committee work
Nursing home experience
RN License
Interdisciplinary collaboration in health services social work
Psychosocial interventions
Medical claim appeals
Clinical social history assessment
Mid-level
Community resource coordination in health services social work
3 years
Medical social work
Quality reports
Managing patients as a nurse case manager
Care planning in social services
Transitional care planning in clinical case management
One-on-one patient counseling
Professional development support
Bachelor's degree
Pre-authorization review for utilization management
InterQual
Utilization management
Task prioritization
Client referral services
Quality compliance management
Patient care
Continuous clinical improvement initiatives
Resource utilization in healthcare
Medical insurance appeals management

Full Job Description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary:

The Case Manager coordinates the hospital’s utilization review activities. Completes CQI Monitors for RM Committee and assures compliance with Federal, State and Third Party Insurance guidelines. Coordinates discharge planning, patient teaching and other associated activities for discharge to nursing facilities or successful community re-entry

Responsibilities:

1. Monitors UR activities/resource utilization

a. Reviews for appropriateness of admission and continued stay

b. Obtains patient precertification to prevent possible payor denials

c. Appropriately follows through with Payor Denials with appeal process

d. Confers with physician and/or refers to physician consultant when “Medical necessity” for admission or continued stay is questioned
- - Completes chart review within 24 working hours and obtains precertification within 48 working hours to appropriately monitor UR activities and prevent payor denials.
2. Interviews patients/families and records in Medical Record, Makes referrals.
- - Documenting psychosocial, financial, cultural, domestic violence and protective services situations. Refers if necessary.
  - Develops plan to meet needs
  - Provides brief counseling services
  - Completes case findings, assessments, and treatment plans as per policy in order to provide effective intervention.
3. Coordinates/promotes patient teaching.
- - Provides education and implementation of AMD and DNR, documents to patients as needed
  - Provides and identifies appropriate resources to meet educational needs of staff, patient, physician or community agency
  - Coordinates activities in conjuction with other multidisciplinary team members to meet educational needs.
4. Coordinates discharge planning between community agencies, interdisciplinary team, patients/families and physicians.
- - Identifies appropriate level of care for nursing home placement/extended care
  - Completes FL2, PASARR approval process
  - Maintains working knowledge of financial and community resource regulations/availability
  - Coordinates continuity of care in order to facilitate transition from LMH.
5. Serves as a resource person for families, staff, community agencies and physicians.
- - Assists with learning needs of staff
  - Participates in job-related seminars and in service education
  - Serves on hospital committees addressing managed care/length of stay
  - Utilizes resources as appropriate
  - Collaborates with other health care professionals in order to provide comprehensive quality care to patients and families.
6. Demonstrates Autonomy.
- - Completes tasks as assigned
  - Seeks and accepts additional job responsibilities and learning experiences
  - Sets priorities according to patient needs
  - Operates within parameters of hospital and department policies
  - Demonstrates appropriate time management
  - Seeks opportunities for professional growth
  - Takes personal responsibility and initiative for performance and for professional growth and development.
7. Coordinates/promotes patient teaching.
- - Promotes education and implementation of AMD and DNR, documents to patients as needed.
  - Provides and identifies appropriate resources to meet education needs of staff, patient, physician or community agency.
  - Coordinates activities to facilitate learning in accordance to needs assessment.
  - Includes patient/family and/or significant other in patient education plan.

Other information:

- EDUCATION
- - Graduate from an accredited school of nursing or Medical Social Worker. Baccalaureate Degree in Human Services area accepted.
- EXPERIENCE
- - Three to four years experience in hospital, nursing home, or community agency.
- LICENSURE/REGISTRATION/CERTIFICATION
- - Certification by American Board of QA/UR or InterQual, Certification in Social Work, Licensed in N.C. for RN or LPN
    Obtain Case Manager Certification within 5 years.

Job Details

Legal Employer: Lenoir Health

Entity: UNC Lenoir Health Care

Organization Unit: Care Management

Work Type: Per Diem

Standard Hours Per Week: 4.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: LENOIR MEM

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

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case manager jobs in pink hill, nc

Case Manager

Residential Case Manager

Home Health Registered Nurse Case Manager

Case Manager, RN or Social Worker (BSW)

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