Pella Regional Health Center Case Management Specialist in Pella, Iowa
Collaborates with the interdisciplinary healthcare team to ensure the delivery of high quality evidence-based care. Uses current utilization review practices, Milliman criteria and appropriate clinical judgment to support the team and coordinate care for discharge planning, transitions of care, provision of ancillary services and follow up communication.
Minimum knowledge, skills, and abilities:
Degree in the field of HIM, Social Work or Nursing. Registered Nurse must be a graduate of an accredited nursing program. RN licensure in the State of Iowa.
Experience in Case Management preferred.
Current American Heart Association (AHA) Heart Code BLS required. New employees certify within three (3) months after hire date.
3 years minimum previous hospital/ acute care experience.
Knowledge of insurance, utilization review, Medicare, Medicaid
Knowledge of JCAHO requirements.
Ability to read and communicate effectively in English.
Strong written and verbal skills.
Basic computer skills, Microsoft office, Outlook.
Must demonstrate critical thinking skills and decision-making ability.
Ability to communicate with tact and professionalism.
Ability to work independently.