Hospital Case Manager - TBG | The Bachrach Group

Hospital Case Manager:

A Hospital Case Manager plays a crucial role in coordinating patient care and ensuring efficient utilization of resources within a medical facility. They work collaboratively with social workers, physicians, nurses, and other medical staff to provide essential medical assistance and care to patients. Here are the primary responsibilities:

Discharge Planning

• Create discharge plans to determine if patients need further help or care after leaving the hospital.
• Communicate with patients or their families about post-discharge steps, such as arranging for home care or follow-up appointments.

Insurance Information Compilation

• Acquire and compile necessary insurance information from patients.
• Understand patient ailments and negotiate with insurance companies to prevent claim denials.

Utilization Reviews

• Conduct utilization reviews to ensure adherence to protocols and optimal patient care.
• Evaluate whether patients are receiving the best care for their conditions or illnesses.

Qualifications

• RN license is preferred. LSW, or LCSW is a plus.
• Bachelor’s degree in a related field.
• 2+ years of healthcare experience, preferably in a case management role.
• Case management certification is a plus.