Fairview Health Services  Utilization Case Management Coordinator in Twin Cities, Minnesota

JobTitle Utilization Case Management Coordinator

Specialty Behavioral Services

Location University of Minnesota Medical Center (West Bank)

Department Utilization Mgmt Behavioral

Hours per 2 weeks 80

Shift Day

Date Posted 05/17/2018

Job Number 18-72919

Job Description:

The Utilization Manager - Case is responsible for coordinating the Utilization Management activities for Behavioral Services in order to assure the ongoing, comprehensive monitoring and evaluation of patient care, by concurrent and retrospective review to assure appropriate reimbursement. Completes assessments of potential admissions including financial aspects.

*Implements case management theory and practice to ensure cost effective quality patient care and maximize reimbursement:

*Promotes change and increases referrals to program by educating staff and other health care professionals regarding effective hospital resource use and other options available.

*Facilitates flow of information within the hospital and between hospitals, physicians and payers related to certification requirements and reimbursement systems in order to maximize reimbursement.

*Reviews medical records to verify appropriateness of patients for admission for sub acute care.

*Communicates with staff on each campus including, but not limited to the results of assessments, financial information, etc.

  • Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.

Job Qualifications:

Minimum Education

BA or BS in Nursing or Associates degree with

directly related experience totaling 4 years.

Minimum License/Certification/Registration

MN RN licensure

Minimum Experience

3 - 5 years clinical experience

Preferred Experience

Broad based clinical experience

1 year utilization management

About Fairview Health Services

Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Joined by HealthEast in June 2017, Fairview is one of the most comprehensive and geographically accessible systems in the state, with 11 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area and north-central Minnesota.

Its broad continuum also includes 56 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.

EEO/AA Employer/Vet/Disabled

All qualified applicants will receive consideration without regard to any lawfully protected status.