Clinical Case Review Jobs in Georgia

Work Shift

Day

Work Day(s)

Monday-Friday

Shift Start Time

7:30 AM

Shift End Time

4:30 PM

Worker Sub-Type

Regular

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

Job Description

Provides for patient care coordination and ongoing program review to ensure appropriate progress with patient/family moving through the continuum of care with the ultimate goal of returning to the home/community. Maintains necessary documentation and communication with external case managers and/or payors for insurance re-certification. Coordinates patient/family copayment responsibilities with Patient Accounts. Maintains patient program evaluation documentation, e.g., outcome measures. Analyzes trends and reports for quality improvement purposes. Proactively supports efforts that ensure delivery of safe patient care and services and promote a safe environment at Children's Healthcare of Atlanta.

Experience

1 year of experience in case management in a hospital environment

Preferred Qualifications

• Master's degree
• Previous experience in a rehabilitation hospital, pediatrics preferred
• Previous discharge planning, Utilization Review and/or care coordination helpful

Education

Bachelor's degree

Certification Summary

Licensure as a Registered Nurse in the single State of Georgia or Multi-State through the Enhanced Nurse Licensure Compact or Certified Rehabilitation Counselor (CRC), Certified Disability Management Specialist (CDMS), Certified Case Manager (CCM) or certified/registered in social work, occupational therapy, physical therapy, physical therapy assistant, or speech-language pathology

Knowledge, Skills, and Abilities

• Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment
• Must successfully pass Epic training within 30 days of employment

Job Responsibilities

• Facilitates ongoing re-evaluation/oversight of patient treatment or intervention program(s) and level of care, working with clinicians, physicians, service providers, educational programs, and appropriate team members to determine and maintain proper level of care.
• Assists in discharge timeframe and appropriate discharge placement.
• Communicates with external case managers, physicians, and/or payors to update on patient medical progress and produce letters of medical necessity for insurance re-certification and determine proper level of care.
• Performs discharge planning to facilitate a smooth transition to appropriate setting, linking family/child with community resources and providing support systems to maintain a realistic viable plan.
• Obtains approval and orders all equipment essential for post-discharge care.
• Maintains therapeutic relationship with patient and family and communicates relevant information at the patient/family level of understanding.
• Identifies patient/family need for services from ancillary departments and provides follow-up and referral as necessary.
• Participates in maintaining and monitoring the work environment to ensure a continual state of Joint Commission readiness.

Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.

Primary Location Address

1001 Johnson Ferry Rd

Job Family

Rehab