Care Continuum Case Manager

University of Southern California; United States; On-site; USD 63,000 - 105,000; Full time

Job summary

Keck Medicine of USC is seeking a Case Manager to support physicians and the interdisciplinary team in delivering patient care, improving outcomes, and managing costs. The role oversees a designated caseload and coordinates utilization management, care facilitation, and discharge planning.

Key duties include coordinating pre-certification and payer authorizations, removing barriers to timely care, guiding documentation accuracy, and communicating with physicians and payers to ensure appropriate

Qualifications

• Knowledge of discharge planning and utilization management in health care.
• Strong interpersonal, negotiation and communication abilities.
• Ability to prioritize tasks with organization and time management.
• Understanding of pre-acute and post-acute care and community resources.
• Analytical and data management skills; proficient with PC applications.

Responsibilities

• Actively participates in clinical performance improvement activities.
• Applies InterQual criteria to monitor admissions and stays and documents findings.
• Assists in compiling physician profile data on LOS and costs.
• Collects financial indicators including case mix and readmission rates.
• Collaborates with the multidisciplinary team in discharge planning.
• Coordinates communication with physicians and payers for care plans.
• Documents discharge planning information in patient records.

Skills

Discharge planning

Utilization management

Performance improvement

Communication skills

Negotiation skills

Time management

Data management

PC skills

Education

Associate's Degree in Nursing

Job description

Keck Medicine of USC is seeking a Case Manager to support physicians and the interdisciplinary team in delivering patient care, improving outcomes, and managing costs. The role oversees a designated caseload and coordinates utilization management, care facilitation, and discharge planning.

Key duties include coordinating pre-certification and payer authorizations, removing barriers to timely care, guiding documentation accuracy, and communicating with physicians and payers to ensure appropriate