Hospital - Lead Case Manager

Job description

Under minimal supervision, manages cases to enhance the quality of patient management and satisfaction. Promotes continuity of care and cost effectiveness through integrating functions of case management, utilization review and management, and discharge planning. Functions as a subject matter expert in areas that significantly enhance care delivery such as staff education, policy development, quality assurance and/or leadership. Will provide continued support to care management team. 1. Promotes and demonstrates the professional image of care management in demeanor, appearance, attitude, and behavior. 2. Conduct utilization reviews to ensure medical necessity, appropriateness, and efficiency of healthcare services. Address and resolve any issues related to care coordination, including gaps in services or communication barriers. 3. Develop and update policies and procedures related to care management to ensure they align with best practices and regulatory requirements. 4. Covers departmental operations as requested or in the absence of the Director of Care Management. 5. Oversee the coordination of patient care, including discharge planning and transitions of care. Collaborate with...