Responsibilities:

Job Summary: The Case Manager oversees the process of care delivered to patients, works collaboratively, and provides leadership to the healthcare team, and is committed to organization goals. Case Manager examines records for medical treatments and interventions to avoid payment denial resulting in optimization in reimbursement by assessing appropriateness of treatments, effectiveness, timing, and setting. This includes observation level of care vs inpatient level of care based on medical necessity. This role also includes patient assessment for discharge planning as well as appropriateness of level of care based on medical necessity. Case Manager is integral in minimizing and assisting with barriers to discharge.