Case Manager

Highland Hospital

Charleston, West Virginia, US
Competitive salary commensurate with experience; n...
Not specified
Analyze client records for admission appropriateness
Coordinate discharge planning and post-hospitalization care
Appeal insurance denials effectively
Highland Hospital is seeking a Case Manager to oversee patient admissions, treatment plans, and discharge coordination, ensuring compliance with clinical criteria and reimbursement policies. The ideal candidate will have a Master's degree in social work or nursing, experience in communication with external review organizations, and a solid understanding of psychiatric care

Job Summary

  • The Care Manager is responsible for reviewing admissions, continued stays, and discharge coordination according to clinically valid criteria.
  • This role requires analyzing insurance and government regulatory standards to determine appropriate length of stay and treatment plans.
  • Highland Hospital offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.

Matching Summary

Match Score: 85

Highland Hospital is seeking a Case Manager to oversee patient admissions, treatment plans, and discharge coordination, ensuring compliance with clinical criteria and reimbursement policies. The ideal candidate will have a Master's degree in social work or nursing, experience in communication with external review organizations, and a solid understanding of psychiatric care.

Salary

Competitive salary commensurate with experience; Not specified; Comprehensive benefit plan included

Skills & Requirements

Must-have

  • Analyze client records for admission appropriateness
  • Coordinate discharge planning and post-hospitalization care
  • Appeal insurance denials effectively
  • Communicate with multidisciplinary medical teams
  • Maintain confidential utilization review files

Nice-to-have

  • Direct clinical experience in psychiatric settings
  • Collaborative work with family members
  • Knowledge of community resources and support groups
  • Engagement in treatment team meetings

Key Requirements

  • Master's degree in social work, mental health, or nursing
  • One year experience with external review organizations
  • Valid RN or LPN license if applicable
  • CPR and de-escalation certification required
  • Working knowledge of payor resources and financial planning

Work Rights

Not specified

Tailored Resume

Cover Letter