Case Manager, Full Time

Mercy Iowa City is actively seeking a Full Time Case Manager to join our team!

Pay Range: $27.52-$41.22 per hour

Position Summary

To perform review activities relative to assuring appropriate utilization of hospital services, assessing, facilitating and obtaining appropriate resources for identified continuing care needs. Assessing patients, beginning with the admission review, to determine medical necessity, appropriate level of care and potential needs after discharge, and to initiate the discharge planning process. Communicates review findings to physicians, managed care organizations, insurance companies, long-term and/or home care facilities, patients and families.

Job Duties

• Confers with patient and families regarding available resources for post discharge needs and coordinate needed resources.
• Communicates difficult and/or problematic cases to the manager as indicated; provides periodic updates to the manager regarding changes in patient status and/or concerns.
• Communicates level of care information and treatment plans to insurance companies, managed care organizations, home health and/or long term care facilities.
• Coordinates community health resources for patients and patient families in the outpatient and mental health care areas.
• Discusses cases with interdisciplinary team members as needed to optimize the discharge plan. Keeps abreast of changes in utilization management and discharge planning by attending in- services programs/workshops and reading current literature.
• Performs other duties as assigned.
• Confers with patients regarding insurance benefits as it relates to the necessary level of care and/or discharge planning needs.
• Reviews medical records of patients currently hospitalized to evaluate level of care, to assess continued need for acute care and to assess potential need for community resources after discharge; to confer with physicians, nurses, and other appropriate hospital personnel to determine and document appropriateness of patient admission and continued need for hospital care; collect data as appropriate.
• Assesses and evaluates patients for appropriateness of transfers to other facilities and facilitates transfers and/or placements as needed; completes necessary transfer documents and notifications.
• Refers questionable cases relative to discharge planning activities to the leadership for follow-up.