Full-Time Tele-Case Manager | Texas

Job Title:

Full-Time Tele-Case Manager

Academic Background:

Certified Case Manager, Strongly Preferred

Experience:

3+ Years Case Management | Background in the Inpatient & ED Setting

Must be Qualified to Lead the Program Independently

Salary Range:

$57,400 Annual Salary

Overview: Beam Healthcare seeks an experienced case manager for our inpatient and ED case management program. The role of the Case Manager is to help ensure patients are appropriately managed from admission through discharge. Tele-coverage for an inpatient setting in Texas.

Schedule of Tele-Coverage Service

• Monday through Friday, 8:30am - 4:00pm.
• Full-Time split between two Case Managers (flexible scheduling decided between team members) or in coordination with a Full-Time team member to support a growing program.
• Flexibility to help with other team members' vacations/sick time.
  
  
  

Daily Job Responsibilities:

• Actively work with the ER/hospitalist for any new obs/admission requests to ensure proper status from admission.
• Ensures compliance with Condition of Participation (CoP) discharge planning.
• Identifies and escalates gaps/barriers related to inpatient and observation length of stay.
• Attend Patient/Family meetings as needed.
• Assesses patients at high risk for readmission. Identifies root cause for readmission. Develops plan and collaborates with multidisciplinary team regarding discharge planning to next level of care.
• Provides discharge care coordination for HHS, Hospice, ALF, and SNF. Communicates with health unit coordinator for appointments/follow ups and therapy re: DME needs prior to and upon discharge.
• Participates with other members of team regarding opportunities for improvement in standard work.
• Actively participates in utilization management and admission processes and acts as a liaison with post-acute providers (skilled nursing facilities, rehab, home health, etc.).
• Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's Scope of Service.
• Performs other duties as assigned.
  
  
  

Administrative Responsibilities:

• Utilization review on an ongoing basis.
• Lead monthly UR meetings, including monthly reports with trends and input. This will also be sent to CEO, CFO, CNO, and Hospitalist director + Med Surg manager.
• Aid in Insurance authorization coordination.
• Weekly meeting prn with PFS regarding authorizations and denied claims.
• Denial coordination with the business office on hospitalized patient denials.
• Prepare for Monthly UR meetings, including monthly reports with trends and input.
  
  
  

Required Skills:

• 3+ years prior case manager experience in the inpatient and ER setting.
• Knowledge and scope to perform assessments and qualify ER patients.
• Certified Case Manager, strongly preferred
• Excellent knowledge of case management principles, healthcare management, and reimbursement
• Proficiency with case management software platforms: Milliman and Interqual.
• Excellent written and verbal communication skills.
  
  
  

About Beam Healthcare:

Beam Healthcare is looking for a Case Manager to join our growing team of providers, administrators, analysts & friends who share the vision of Healthcare Equality. Our partnerships with all types of healthcare organizations are strengthened by our commitment to providing quality-based care with a team-based approach.

Our motto of “Telemedicine Moving Forward” signifies a proactive approach to system change,whereby we enhance patient care in communities we serve by implementing evidence-based,innovative solutions. This allows us to exceed quality goals while building a strong foundation for the future of medicine. The future of medicine is not limited by social or geographical boundaries. Are you ready to extend the reach of your expertise?