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Northeast Georgia Health System
Gainesville, Georgia
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WakeMed Health & Hospitals
Raleigh, North Carolina
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Registered Nurse, (RN), ED Access Case Manager, Full Time, Days 7:00A-7:30P 12hr
The RN Access Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to coordinate admissions, transfers and repatriation to PHDH through the emergency room or direct admission. The RN Access Case Manager works closely with insurance and various payor to coordinate and assist with reparation/transfer of out-of-network patients from PHWH to the patient’s contracted facilities. The RN Access Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve authorization and reimbursement for services for the appropriate level of care and status (Inpatient, Observa
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