RN CASE MANAGER I - SPECIAL NEEDS
Location: Philadelphia, Pennsylvania, United States
Base Salary - USD $82,000 to $95,000
Overview:
We are a 188-bed facility that provides exceptional care to children throughout the Greater Philadelphia area and surrounding counties.
We have more than 220 pediatric experts on staff, combining top-notch pediatric care with a wide array of pediatric specialties including Cardiology, Ear, Nose and Throat, Gastroenterology, Oncology, and Orthopedics. It houses the only Verified Pediatric Burn Center between New York City and Baltimore and is one of only three Level I Pediatric Trauma Centers in Pennsylvania. We have a Magnet designated hospital and was recognized as a Women’s Choice Award Best Children’s Hospital.
In addition to its main location in Philadelphia, the hospital has a growing network of primary and specialty care locations throughout the Philadelphia suburbs and New Jersey so your child's health conditions can be treated close to home.
Responsibilities:
The Case Manager coordinates, manages, and procures the discharge needs of patients identified as requiring post-acute care services via initial admission screen, assessment, and consults. This is achieved by collaboration with the family, the care team including physicians, nursing, and other healthcare professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information to third-party payers to secure appropriate acute care reimbursement within the time requirements of the payer. The Case Manager appeals 100% of all third-party payer denials for acute care reimbursement according to the guidelines for the PA Region. The Case Manager performs ongoing PI/QA during concurrent review to identify quality of care issues, risk management issues, and performs blood/blood products and medication utilization.
Qualifications:
Education Requirements
4-year/bachelor's degree
Experience
Relevant Experience
Certification and Licensure
PA Registered Nurse License
Required Skills
Computer Skills to include use and navigation.
Excellent Communications Skills
Excellent Interpersonal Skills
Microsoft Word
COMPENSATION
Base Salary - USD $82,000 to $95,000