Performs Case Management activities to assure medical necessity of admissions and appropriateness of continued stay utilizing the Interqual Criteria guidelines. Monitors the utilization of resources of all patients reviewed. Maintains confidential communication with physicians and multi-disciplinary personnel to meet individual needs or the patients served. Functions as an independent contributor as well as a team member.
Communication is an essential skill requiring the ability to see, hear, and speak. Fluent in written and spoken English.
Must be able to fulfill the essential functions of the position.
Possess three or more years of acute care hospital experience preferred. Familiar with the operations of the healthcare industry and healthcare delivery systems.
Able to use the medical record in order to obtain clinical information to perform Interqual reviews.
Utilize Outlook, and the computer based systems (AllScripts) to perform reviews.
Work experience in Mental Health required.
Medical-Surgical, Telemetry, Critical Care, and/or Pediatrics, NICU preferred.
Current Florida RN Licensure. Must possess a solid clinical background to accomplish extensive Medical Record review. Computer skills preferred
Job: Case Management/Home Health
Primary Location: Hialeah, Florida
Facility: Palmetto General Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.