ProHealth Care - Oconomowoc Memorial - Case Manager Full Time
We Are Hiring: Oconomowoc - Case Manager - Full Time
Schedule Details: 40 hour per week. Weekend rotation (typically 1 weekend per month). Holiday rotation.
Begin your story with ProHealth Care. Here we offer a culture that's warm, welcoming, and vibrant. Additionally, we offer a generous benefits plan and resources to help you further your education. After all, it's the way you should be treated. Enjoy our video series featuring our own employees sharing why they choose ProHealth Care and what they enjoy about working here.
Culture is built every day, and we want you to be a part of this. If you're like us and are passionate about providing exceptional patient care, we'd like to meet you!
What You Will Do:
As a member of the Care Management team, the Case Manager (CM) is responsible for facilitation of precertification and payor authorization processes and status determination at the point of entry in to the hospital from outpatient areas including cath. lab, day surgery and physician offices. This position will proactively prevent denials through assessment and application of Milliman Care Guidelines to determine status for appropriate reimbursement and bed placement. RN CM also facilitates collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. RN CM's actively participate in the discharge planning process for all patients working collaboratively with payors, providers, patients and families.
Ideal candidate possesses:
Excellent communication and negotiation skills
Strong analytical and computer skills with prior EPIC experience helpful
Experience with pre-acute and post-acute care, as well as, community based resources
Ability to work independently and collaboratively with the care providers and business office staff is necessary
Promotes safety, cost efficiency and a commitment to quality improvement.
What you will need:
Associate's Degree in Nursing (BSN in nursing preferred)
Current Wisconsin RN license required
Current Basic Life Support (BLS) certification
Why Join ProHealth Care:
We have nearly 5,000 dedicated clinical and non-clinical employees and physicians who work together every day to serve the health and well-being of our community. At ProHealth Care everyone contributes to the care our patients receive. And, everyone is treated with kindness and respect in our welcoming environment.
This Position Will Offer You:
- Engaging and community focused culture
- Competitive Salaries
- Opportunity for professional career growth
- Robust benefits including: Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social and sporting events
ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
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Nearest Major Market: Waukesha
Nearest Secondary Market: Milwaukee