Provides utilization review services; assisting with identifying medical necessity for hospital admission and discharge; identifies appropriateness of hospital admission status and coordinates the discharge planning and safe transition process and follow-up.
In order to meet the patient's safety and healthcare needs, the case manager works with the provider, interdisciplinary team, the patient and family to facilitate a plan of care in the hospital and coordinate post hospital care to promote a balance of quality and cost effective care.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Education: Bachelor's Degree preferred
License/Certification: Active nursing license. Certification in Case Management preferred.
Experience: Minimum of (5) five years' experience preferred
Understanding of health care reimbursement preferred
Proficient computer and communication skills
MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.