Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Competitive salary
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and outcomes
- Utilization of computer-based charting and other clinical software programs
- Ability to work independently and remotely

What to Expect (Job Responsibilities):
- Assess, plan, implement, evaluate, and provide patient care coordination from pre-hospital through post-hospital care
- Assist in the development of physician profiles to identify over/under utilization patterns
- Support Steward Health Care's and hospital goals and objectives within regulatory compliance guidelines
- Collaborate with all healthcare disciplines to assure appropriate and timely services
- Assess the medical appropriateness, quality, and cost-effectiveness of proposed hospital, medical, and surgical services
- Collaborate with the multidisciplinary team to assist patients with benefits management
- Communicate with payers to obtain authorization
- Identify and plan strategies to optimize inpatient length of stay and resource utilization

What is Required (Qualifications):
- Ability to work competently with computer-based charting and other clinical and non-clinical software programs
- Adaptability to change and good organizational skills
- Effective communication skills in English
- Working knowledge of criteria for Medicare, Medicaid, HMO, and private insurance carrier's coverage details
- Ability to advocate for patients and operate office equipment
- Leadership skills including mentoring, coaching, counseling, time management, problem-solving, and strategic planning
- Initiative and proactive approach to problem resolution
- Ability to effectively interact with insurance companies and community healthcare resources
- Ability to work in a stressful, fast-paced environment
- Proficiency in Microsoft Office applications

How to Stand Out (Preferred Qualifications):
- 3-5 years of acute medical/surgical experience plus 3-5 years of Case Management experience
- Certification in Case Management (CCM) strongly preferred

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