Job Summary:

Provides case management services to a caseload of low- and medium-risk patients. Interviews patients and their caregivers to evaluate needs, goals, and current services. Proposes process improvements for determining initial eligibility, benefits, and education for all admissions, leveraging advanced knowledge to assess medical necessity and required level of care to inform physicians. Analyzes and ensures authorization data and escalates inaccuracies. Develops a client-focused case management plan in collaboration with healthcare team, patient, and caregivers that is consistent with regulatory, accreditation, and regional guidelines. Assists patients with gaining access to care based on their needs, making referrals as appropriate. Coordinates resources and services to assure continuity and quality of care. Attends case management rounds with clinician and updates authorizations and diagnoses as needed. Assesses patient progress toward treatment milestones and car...