Attleboro, MA30+ days ago
p>Required Skills/Qualifications/Training/Experience: • Minimum 3-5 years acute care case management experience, with demonstrated skills in utilization review • Demonstrated ability to use critical thinking and problem solving skills in facilitating safe and timely patient transitions of care • Excellent communication skills and positive interpersonal dynamic in working with a variety of stakeholders across the care continuum • Solid knowledge of all insurance plan regulations including CMS/Medicaid to ensure compliance with all required processes and documentation • Ability to garner and utilize information effectively to develop and modify patient plan of care • Strong analytical ability to interpret patient-related information, evaluate appropriateness of continued stay and/or need for ancillary services, and to reassess discharge planning needs based on daily assessment • Ability to successfully utilize industry accepted utilization and or medical management criteria in patient status decision making • Self-starter able to function independently within the scope of position and licensure, as well as department policies and established goals • Excellent computer skills to accurately document requisite information to support patient status and medical necessity.
Physical Demands:
• Ability to sit (may be for long periods of time) • Ability to stand, reach and lift up to 15 pounds • Ability to readily travel to units/departments across the system • Ability to communicate effectively with all stakeholders, in person as well as via telephone and electronically • Ability to interact directly with patients, with potential for direct exposure to patient care activities • Ability to document and use trackers, analyze charts and coordinate services within the electronic health record • Ability to advocate for patients both internally and external to the system • Ability to attend and participate professionally in meetings with Hospital leaders, physicians, patients and families.