Job ID: 295073

RN Case Manager Utilization Review

Dowagiac, Michigan

Regular / Day

We Are Hiring

Case Manager Utilization Rev - Case Management 001 - Part-Time Day 20 Hours Weekly - Borgess-Lee Memorial Hospital - Dowagiac, MI

Why Join Ascension?

Based in Kalamazoo, Borgess provides care for nearly 1 million people annually in cardiac, neurologic, orthopedic, vascular and bariatric services, among others. We are one of the region’s largest health systems and employers and have been serving as part of Ascension since 1999.

What You Will Do

As an Associate with Borgess Health-MI, you will have the opportunity to coordinate the overall interdisciplinary plan of care for patient, from admission to discharge.

Responsibilities:

  • Creates plan for care across the continuum, integrating patient/family preferences and values.
  • Monitors patient care through assessments, evaluations and/or patient records.
  • Advocates for resources and removal of barriers.
  • Maintains ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan.
  • Requires a focus on customer service skills, knowledge of setting appropriate goals and measuring outcomes to effectively ensure optimal patient outcomes consideration to payer requirements.
  • Coordination involves chart review and assessment, planning, support, and evaluation of patient care and outcomes.
  • Utilization management, assurance of comprehensive clinical documentation, maintenance of CAH utilization procedures, appropriate clinical documentation for utilization review and communication with third party payors.
  • Maintains utilization review records in a manner that permits easy retrieval of data. Follows Corporate Responsibility policies and completes modules as required.
  • The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

What You Will Need

Licenses/Certifications/Registration:

  • Required Credential(s):
    • Certified Case Manager obtained prior to hire date or job transfer date. 
    • Finger Printing obtained prior to hire date or job transfer date. 
    • Licensed Registered Nurse obtained prior to hire date or job transfer date. 

Education:

  • Bachelor's degree in Human Services field is required. Master's degree in Human Services field is preferred.
  • Extensive case management is required.

Equal Employment Opportunity

Borgess Health is an equal opportunity employer, dedicated to the nondiscrimination in employment on the basis of race, color, age, religion, sex, national origin, handicap, disability, veteran or marital status.

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.