Utilization & Review Care Manager
You can be part of a comprehensive group of compassionate individuals from admission to discharge.
As a care manager, be responsible for obtaining authorization based on the review of each patient record and establishing a clinical level of care.
Continue following the patients care during their stay by reviewing records on a regular basis.
Should additional authorizations be needed, you would obtain authorization for related services including psychological, medical, chemical dependency and other levels of care.
You would also prepare and submit medical records in cases of appeal.
And finally, assist the treatment team with information related to discharge planning and obtaining authorization as needed.
To qualify, a professional degree in nursing, BA in social work or MA, psychology, health information management or other related healthcare field is preferred OR related experience.
You must also be proficient in PC skills including microsoft software.
You must also have a knowledge of medications and medical terminology.
This is a day shift position working Monday through Friday.
Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.
Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.
Equal Employment Opportunity
Adventist HealthCare is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, marital status, disability or any other basis prohibited by law.