Case Manager

Job Details

Job Location:

Cullman Regional Medical Center – Cullman, AL 35056
Position Type:
Full Time

Job Shift: Day
Job Category:
Nurse

• Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost‑effective care.
• Support physician provision of patient care with accountability for designated patient case load.
• Facilitate precertification and payor authorization processes and facilitate collaborative management of patient care across the continuum, intervening as necessary.
• Promote effective utilization and monitoring of healthcare resources and assume a leadership role with the multidisciplinary team to achieve optimal clinical and resource outcomes.
• Apply process improvement methodologies in evaluating outcomes of care.
• Maintain and ensure adherence to clinical guidelines, tools and protocols based on evidence‑based medicine related to quality measure indicators.
• Assume leadership role in coordinating quality improvement activities related to quality measure initiatives.
• Demonstrate and encourage team behavior and exceptional patient/guest experiences.
• Uphold and promote patient safety and quality.

• Associate’s degree in nursing or higher degree required; currently licensed by the state of Alabama. BSN preferred.

• Five years’ clinical experience in acute care setting (e.g., medical surgery, critical care, ER, OR) required.
• One year experience in Utilization Review with JIVA, Interqual, Cerner, Medicare, HMOs, and other payors.

• Skill and proficiency in applying highly technical principles, concepts and techniques central to case management.
• Advanced communication and interpersonal skills with all levels of internal and external customers.
• Proficient in Microsoft Word and Excel.
• Excellent organizational skills; able to set priorities appropriately and handle multiple issues concurrently.