Manager, Case Management
Job Description
The Manager, Case Management oversees patient care coordination, utilization review, and discharge planning to ensure quality outcomes and cost-effective care. This role manages case managers, establishes best practices, and collaborates with healthcare providers, patients, and families. The manager ensures compliance with hospital policies, regulatory standards, and insurance requirements while enhancing patient satisfaction. Strong leadership, clinical knowledge, and communication skills are essential for delivering integrated and effective case management services.
Key Responsibilities
- Lead case management team ensuring compliance with hospital standards daily.
- Coordinate patient care plans with physicians, nurses, and healthcare staff.
- Monitor utilization review ensuring appropriate medical necessity and efficiency.
- Oversee discharge planning, ensuring smooth transitions and post-care support.
- Evaluate case management processes and implement continuous quality improvement.
- Manage patient and family communications for education and support.
- Ensure compliance with insurance requirements and healthcare regulatory guidelines.
- Prepare reports, analyze data, and present outcomes to leadership.
Skill & Experience
- Strong leadership abilities with proven experience in healthcare management.
- Excellent communication skills for interacting with patients, families, providers.
- Knowledge of utilization review, discharge planning, and clinical guidelines.
- Analytical skills to evaluate patient outcomes and improve processes.
- Problem-solving ability for resolving case complexities and system challenges.
- Proficiency in healthcare software and electronic medical record systems.
Note: Salary is disbursed in the local currency of the country of employment.
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