All the benefits and perks you need for you and your family:  

Our promise to you:  

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.  

Schedule:  

Shift:  

Location: 100 Hospital Drive, Hendersonville, NC 28792 

The community you’ll be caring for: AdventHealth Hendersonville 

The role you’ll contribute:  

Supervise Case Managers and Discharge Planners who follow patients from pre-admission through discharge to home, nursing/rehab facility or home care program. Assure appropriate discharge planning for the patient and family and comply with all regulatory and financial guidelines. Oversee utilization review, house supervisor and discharge planning

The value you’ll bring to the team:  

• Maintains and utilizes current knowledge of utilization review criteria and reimbursement guidelines to serve as a resource person for the Care Management Department. Acts as a resource for medical staff, interpreting requirements of federal, state and third-party payer guidelines for coverage.
• Identifies potential for over and underutilization of hospital resources, non-acute and potentially avoidable days, takes appropriate interventions, trends and reports data.
• Collaborates with nursing and other clinical staff to achieve optimal clinical outcomes.
• Conducts multidisciplinary case conference to promote communication about patient status and future plans and to assure coordination of care.
• Demonstrates appropriate clinical knowledge in order to assist physicians in providing complete documentation of severity of illness and intensity of services in order to assure that criteria for acute hospitalization are met. Acts as a liaison with physicians to assure that aspects of treatment are fully documented and to assist in identifying other options for care when acute hospitalization is no longer required. Interacts appropriately with physicians, providing information, suggesting alternatives, and assisting in securing timely referrals.
• Secures physician advisor reviews on a timely basis in cases of potential denial of medical necessity for admissions or continued stay. Provides feedback regarding potential risk and participates in the process of delivering notices of non-coverage.
• Continually evaluates opportunities to make the case management system more effective. Identifies suggested improvements to the system by using information from outcomes analysis.
• Promotes case management through role modeling and the education of other staff members on case management benefits and concept.