Job Summary

Manager of Case Management in the departments activities and resources to achieve departmental and organizational objectives and will take the lead in the absence of the Director. Accountable for the execution, adaptation, and outcome of care management as described in the initial UM plan with regard to resources, appropriateness of care and adherence to a designated GMLOS for each patient.

COMPANY DESCRIPTION

Frye Regional Medical Center, located in the beautiful foothills of North Carolina is a 355-bed acute care hospital, 81-bed Behavioral Health facility and more than 70 primary and specialty care providers.

Essential Functions

1. Monitors the daily assignment and makes adjustments as needed to maintain an evenly distributed caseload for CM’, SW’s, and D/C Planners

2. Keeps staff up to date on their time in kronos; fixes missed punches

3. Takes messages off insurance line and communicates information to correct persons.

4. Completes Retro’s as needed and enters days authorized into Cerner for billing purposes.

5. Enters billing changes into Cerner so billing knows correct way to bill; ie direct admits or bill different than status

6. Researches medical records to assist if business office or coding department has questions; also assists revenue integrity with questions

7. Monitors all OBS patients to remain