Beebe Healthcare in Lewes, DE - Creating The Next Generation Of Care
*** Please note Beebe Healthcare Main Campus is located in Lewes, DE with other locations within a 22 mile radius ***
Develops and manages the Case Management Department. All members of the Leadership Team who need to use a phone for business purposes must use a personal cell phone. In order to be considered for the position, please visit our website www.beebehealthcare.orgto fill out an application.
Coding and Criteria knowledge: - basic knowledge with ICD9 and CPT coding as required to follow UR Process.
Familiar with standard criteria used in UR/QA Industry.
Ensures compliance with work plans, goals, as well as compliance with all state, Federal, and regulatory requirements as it pertains to Discharge Planning and Utilization Review functions and oversight.
Direct timeliness and accuracy of utilization management, and any discharge planning reporting requirements for regulatory agencies.
Responsibility in management of the activities relating to the monitoring of utilization of resources, efficient proactive discharge planning to ensure effective movement of patients across the continuum of care.
Manages, coaches, and mentors staff accordingly to meet organizational values and behaviors.
Documentation and quality assurance:- able to identify appropriate standards of care- conducts concurrent and retroactive case review- identifies appropriate situations/information for referral to physician advisor/director.
Good working knowledge of UR process.- Review- Certification- Reimbursement- Denial Process- Physician Advisor referrals.
Maintains/updates current policies and practice for Department to assure best practice at all time.
Five years Case Management, Discharge Planning, or Utilization Review in a health care setting.
Master’s degree in Social Work or Nursing.
Knowledge of regulatory compliance for discharge planning and clinical documentation.
3 years leadership in an acute care setting preferred.
Our employees play a pivotal role in our continued success. Attracting and retaining the best healthcare professionals is Beebe Healthcare's top priority. We offer an excellent patient-focused environment, exciting career opportunities, and leading-edge technology with supportive, progressive leadership. Joining Beebe Healthcare means joining an exciting healthcare team that is deeply committed to the community. Join us to take advantage of our excellent benefits and compensation package.