Case Manager, Utilization Review (Per-Diem)

VHC Health; Arlington (VA); On-site; USD 39,000 - 52,000; Full time

Job summary

VHC Health is seeking a Case Manager for Utilization Review on a per-diem basis in the Arlington, VA area. The role coordinates assessment, planning, facilitation, and advocacy to ensure a coordinated continuum of care in line with guidelines and approvals.

The position emphasizes collaboration with the interdisciplinary team, patients, and families to promote timely, clinically appropriate discharge planning, while addressing payer communications and benefits clarifications as needed.

Qualifications

• Graduation from an accredited school of social work, nursing, in a related field or equivalent is required.
• Five years of experience in the healthcare field is preferred.
• Experience in case management is preferred.

Responsibilities

• The Case Manager is responsible for assessment, planning, facilitation, and advocacy to meet health needs, coordinating care and resources to promote quality, cost-effective outcomes.
• Maintains communications with payors and the hospital to secure approvals for care and clarify benefits; facilitates discharge planning with community resources.
• Acts as liaison for the interdisciplinary team, patient, and family to ensure timely, appropriate care planning.

Education

Graduation from an accredited school of social work, nursing, or related field

Job description

Position Title

Case Manager, Utilization Review (Per-Diem)

Job Description

Purpose & Scope:

The Case Manager is responsible for the collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have a coordinated continuum of care in accordance with JCAHO and hospital guidelines and serves as liaison for the interdisciplinary team, the patient, and family to ensure a timely, smooth, and clinically appropriate care planning process. The Case Manager also maintains communications with the pay or at the time of admission and throughout the hospitalization to ensure necessary approvals for care and clarification of benefits. They facilitate retrospective reviews and approvals for care whenever necessary, and they implement and coordinate discharge plans utilizing available and appropriate community resources.

Education:

Graduation from an accredited school of social work, nursing, in a related field or equivalent is required.

Experience:

Five years of experience in the healthcare field is preferred.

Experience in case management is preferred.

Certification/Licensure:

None.

Additional Job Description

At VHC Health, every role contributes to exceptional care, better outcomes, and stronger communities.In addition to your base compensation, VHC Health offers a comprehensive benefits package, including medical, dental, and vision coverage (subject to eligibility requirements), as well as additional wellness and retirement benefits designed to support our employees and their families.VHC Health is committed to wage transparency and equitable pay practices. The compensation offered for this position—whether expressed as an annual salary or hourly rate is determined based on a variety of legitimate, non-discriminatory factors. These factors include, but are not limited to, a candidate’s qualifications, relevant training and experience, skill level, shift differentials (where applicable), internal equity, and current market conditions.The posted hiring range reflects the range VHC Health, in good faith, believes is appropriate for this role at the time of posting. This range may be adjusted in the future based on business needs or market changes. No portion of compensation is considered earned until it is vested and determined in accordance with the terms of applicable policies and benefit plans. The availability and amount of any bonuses, incentives, or other benefits are subject to the terms of those plans and may be modified at the sole discretion of VHC Health, in accordance with applicable law.VHC Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.VHC Health maintains a drug-free workplace. The unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited at all VHC Health locations.