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Requisition Number 19-0013
Post Date 2/4/2019
Title Case Manager
City Birmingham
State AL
Description Nurses: join one of the Best Places to Work (as awarded by the Birmingham Business Journal)!
The Case Manager assists in the development, coordination, and administration of the activities involved in Utilization Review and Discharge Planning. This position performs daily reviews of medical records to determine appropriateness and necessity of admission, continued hospital stay, and ancillary services. These duties may be performed on site or telephonically depending on the location. This position will travel to local areas through a reliable means of transportation insured in accordance with Company policy.
Check out our great benefits and learn more about a future with VIVA Health at vivahealthcareers.com.
Requirements REQUIRED:
• Graduate of an accredited program of professional nursing, ADN/BSN
• Current RN License in good standing with the State of Alabama Board of Nursing
• 3 years of clinical experience in acute/post-acute care, case management, home health, or behavioral health
• Valid driver's license in good standing
• Knowledge of community resources
• Knowledge of Medicare and Medicaid regulations
• Knowledge of medical claims and claims review process
• Ability to be flexible, adaptable, and able to work effectively in a variety of settings
• Demonstrate excellent customer service skills through written and verbal communication
• Basic computer skills.
PREFERRED:
• Utilization Review experience
• HMO or MCO experience
• Disease-management experience
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An Equal Opportunity Employer