Top 119 Utilization Jobs in Alexandria, La

Emergency Department Care Manager - Case Management
Christus Health —Alexandria, LA
- Full-time
- Master of Social Work
- Nursing
- RN License
8d
Distribution Planner/Scheduler
Cleco —Pineville, LA
- Full-time
- Customer service
- 5 years
- High school diploma or GED
7d
EMS Support Analyst
Cleco —Pineville, LA
- Full-time
- Computer science
- Computer Science
- Research
MDS Coordinator -LPN/RN
HILLTOP NURSING & REHABILITATION CENTER —Pineville, LA
- From $26 an hour
- Full-time
- Anatomy knowledge
- RN License
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
7d
Clinical Director-Surgery General-Full Time
Christus Health —Alexandria, LA
- 8 hour shift
- Nursing
- Surgery
- Patient monitoring
Clinical Director - Telemetry / Nursing Leadership
Christus Health —Alexandria, LA
- Full-time
- Nursing
- Patient monitoring
- RN License
CDL-A Teams: $10,000 Sign On Bonus/split & Top Pay!
U.S. Xpress —Louisiana
- $0.72 - $0.80 per mile
- Full-time
- DOT physical examination
- Pass drug screening
- CDL A
- AD&D insurance
- Employee stock purchase plan
Quick Apply
Industrial Operations Specialist
Crest Industries —Pineville, LA
- Full-time
- Mid-level
- Analysis skills
- Organizational skills
- Paid holidays
- Disability insurance
Assistant Director of Human Resources
Crest Industries —Pineville, LA
- Full-time
- 3 years
- Analysis skills
- Bachelor's degree
Auxiliary Services Coordinator
Louisiana State University —Alexandria, LA
- Full-time
- Background check
- Sales
- Mid-level
- Paid holidays
- Dental insurance
8d
Home Manager
LA Health and Rehab, Inc. —Pineville, LA
- $15 - $18 an hour
- Full-time
- Mid-level
- Residential
- Rehabilitation center
Quick Apply
Quality Manager
Adolfson & Peterson Construction —Alexandria, LA
- $104,000 - $172,000 a year
- Full-time
- 6 years
- Construction site
- Engineering
- Health savings account
- Paid holidays
11d
Asset Manager
Cleco —Pineville, LA
- Full-time
- Engineering
- Finance
- Analysis skills
11d
Delivery Assistant - Alexandria
MOCKLER BEVERAGE COMPANY -- WEST —Alexandria, LA
- $28,000 - $40,000 a year
- Full-time
- 18 years or older
- Clean driving record
- Sales
Biology Instructor
Central LA Technical Community College —Alexandria, LA
- Full-time
- Classroom
- Word processing
- Writing skills
Legal Assistant/Paralegal - Alexandria
Gordon McKernan Injury Attorneys —Alexandria, LA
- Full-time
- Mid-level
- Organizational skills
- Communication skills
- Paid parental leave
- Disability insurance
Quick Apply
Regional Operations Manager - Site Solutions Megasites
EquipmentShare —Boyce, LA
- Background check
- Up to 50% travel
- Construction site
- Paid holidays
- Health insurance
Quick Apply
1d
Senior Project Manager
Adolfson & Peterson Construction —Alexandria, LA
- $116,000 - $192,000 a year
- Full-time
- 6 years
- Construction site
- Travel
- Health savings account
- Paid holidays
14d
Plasma Operator
Hayes Manufacturing —Pineville, LA
- Basic math
- Forklift
- High school diploma or GED
1099 Patient Care Associate (Alexandria, LA)
AOTI —Alexandria, LA
- Remote
- Mid-level
- Driver's License
- Travel
Quick Apply
14d

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Emergency Department Care Manager - Case Management

Christus Health -
Alexandria, LA

Apply Now

Job Details

Full-time
8 days ago

Qualifications

Managing patients as a nurse case manager
Pre-authorization review for utilization management
Acute care experience
Medical terminology

Full Job Description

Description

Summary:

The Emergency Department (ED) Care Manager is responsible for establishing, coordinating, and maintaining the process to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The Care Manager collaborates with the patient and/or family, multidisciplinary team, physicians, community partners, and payers to ensure the patient’s progress and level of care are appropriately determined. The Care Manager has well-developed knowledge and skill in patient status in the inpatient and outpatient settings and collaborates with other care managers, social workers, Patient Access, physicians, and administrative leadership in the ED to determine the appropriate level of care. The Care Manager also has a robust understanding of services and resources outside of the hospital that would be of benefit to the patient and initiates referrals as indicated. This work includes patient assessment and management, resource management, identifying patients appropriate for admission, observation or outpatient status, care facilitation, discharge planning with referrals to all levels of care, and other duties related to the defined population.

Responsibilities:

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Uses approved criteria to conduct patient assessment and admission clinical review to ensure the appropriateness of setting and timely implementation of the plan of care.
Performs review of anticipated admissions, placements in Observation status, and discharges using evidence-based criteria set for appropriate level of care assignment.
Provides identification of patients for whom standard of care treatments could be safely rendered at home.
Screens appropriateness of admission including observation versus inpatient status.
Educates ED physicians and nurses about medical necessity and admission criteria.
Collaborates with physicians and other members of the treatment team on documentation needs and opportunities.
Utilizes high-risk screening criteria to make appropriate community and post-ED referrals.
Initiates prior authorization process when indicated for post-ED referrals and services.
Escalates to physician advisor when unable to resolve discrepancies with the attending physician.
Manages high-use patients and works to find alternatives for care to frequent ED visits.
Plans for discharges from the ED for patients who do not require admission to include arranging for Home Health, DME, placement, and community resources as they relate to social determinants of health.
Provides patient and family education and counseling about existing health problem-related care.
Anticipates barriers/variances to the delivery of care and intervenes as necessary.
Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.
Coordinates and facilitates patient progression throughout the continuum.
Collaborates with all members of the interdisciplinary team to facilitate appropriate care coordination and care delivery.
Able to analyze clinical information and accurately apply clinical criteria.

Job Requirements:

Education/Skills

Graduate of an accredited school of nursing (BSN preferred) or Master’s degree in Social Work (MSW) required

Experience

3+ years of relevant clinical case/care management experience in the acute care setting required
Familiarity with evidence-based medical necessity criteria sets required
Competency in prior authorization functions and software, including the application of criteria and timelines required
Proficiency in medical and managed care terminology required

Licenses, Registrations, or Certifications

RN or LMSW in the state of employment is required
Case Manager certification preferred
BLS preferred

Work Schedule:

3 Days - 12 Hours

Work Type:

Full Time

Apply Now

Refine Your Search

utilization jobs in alexandria, la

Emergency Department Care Manager - Case Management

Distribution Planner/Scheduler

EMS Support Analyst

MDS Coordinator -LPN/RN

Clinical Director-Surgery General-Full Time

Clinical Director - Telemetry / Nursing Leadership

CDL-A Teams: $10,000 Sign On Bonus/split & Top Pay!

Industrial Operations Specialist

Assistant Director of Human Resources

Auxiliary Services Coordinator

Home Manager

Quality Manager

Asset Manager

Delivery Assistant - Alexandria

Biology Instructor

Legal Assistant/Paralegal - Alexandria

Regional Operations Manager - Site Solutions Megasites

Senior Project Manager

Plasma Operator

1099 Patient Care Associate (Alexandria, LA)

I want to receive the latest job alert for utilization in alexandria, la

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