Company: American Advanced Management, Inc
Location: Hawaiian Gardens
Posted on: June 13, 2021
Using discretion and independent judgment, the Case Manager is
responsible for all case management activities assigned. This
includes case management and utilization management. The Case
Manager provides concise management of patients' hospitalization
from pre-admission through discharge in the areas of patient care,
fiscal management, and Payor/referral satisfaction. The Case
Manager is responsible for conducting Discharge Planning
Evaluations, performing discharge planning to ensure patients and
their families receive maximum benefits, and awareness of community
and government agencies. This position requires the use of
communication skills, the ability to perform management operations
directly related to administrative goals and policies, to provide
regular and direct assistance to executives, to perform work and
special assignments under only very general supervision, and to
continuously develop department operations toward efficiency and
- This position requires a Licensed Nurse with at least three (3)
years of work experience in a medical case management setting.
- Exceptions are made with CEO approval.
- Good organizational and liaison capabilities with
well-developed written and verbal communication abilities are
- Well demonstrated public relations skills with a cooperative
and assertive attitude.
- Working knowledge of the insurance industry is required.
- Have an understanding of the commercial insurance appeal
- Have a working knowledge of billing ad reimbursement and letter
- Be knowledgeable regarding pre-certification and concurrent
- Must have clear and concise professional language in the
preparation of up to date clinical reports representing the
patient's total condition and treatment plan.
- The Lead Case manager, Director of Case Management or a
department representative will participate in a brief portion of
the hospital liaison/ marketing meeting to share positive and
challenging case-specific, case type, or data-based outcomes.
Routine participation allows for a positive exchange of information
between the departments to identify high risk factors that could
potentially affect the outcome of future admissions.
- Have working knowledge of Federal and State Regulatory
- Be responsible to document case-based activities with treatment
plan/ discharge plan interventions.
- As the designated team leader have a good working knowledge and
ability to facilitate interdisciplinary team conference identifying
clinical challenges and outstanding issues.
- Ability to discharge patients successfully without adverse
health consequences with all needs identified.
Keywords: American Advanced Management, Inc, Los Angeles , Case Manager, Other , Hawaiian Gardens, California
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