ProHealth Care

ProHealth Care - Oconomowoc Memorial - Case Manager Full Time


This job is now closed

PayCompetitive
LocationOconomowoc/Wisconsin
Employment typeFull-Time
  • Job Description

      Req#: 107507

      We Are Hiring: Oconomowoc - Case Manager - Full Time

      Schedule Details: 40 hour per week. Weekend rotation (typically 1 weekend per month). Holiday rotation.

      Begin your story with ProHealth Care. Here we offer a culture that's warm, welcoming, and vibrant. Additionally, we offer a generous benefits plan and resources to help you further your education. After all, it's the way you should be treated. Enjoy our video series featuring our own employees sharing why they choose ProHealth Care and what they enjoy about working here.

      Culture is built every day, and we want you to be a part of this. If you're like us and are passionate about providing exceptional patient care, we'd like to meet you!

      What You Will Do:

      As a member of the Care Management team, the Case Manager (CM) is responsible for facilitation of precertification and payor authorization processes and status determination at the point of entry in to the hospital from outpatient areas including cath. lab, day surgery and physician offices. This position will proactively prevent denials through assessment and application of Milliman Care Guidelines to determine status for appropriate reimbursement and bed placement. RN CM also facilitates collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. RN CM's actively participate in the discharge planning process for all patients working collaboratively with payors, providers, patients and families.

      Ideal candidate possesses:

      Excellent communication and negotiation skills

      Strong analytical and computer skills with prior EPIC experience helpful

      Experience with pre-acute and post-acute care, as well as, community based resources

      Ability to work independently and collaboratively with the care providers and business office staff is necessary

      Promotes safety, cost efficiency and a commitment to quality improvement.

      What you will need:

      Associate's Degree in Nursing (BSN in nursing preferred)

      Current Wisconsin RN license required

      Current Basic Life Support (BLS) certification

      Why Join ProHealth Care:

      We have nearly 5,000 dedicated clinical and non-clinical employees and physicians who work together every day to serve the health and well-being of our community. At ProHealth Care everyone contributes to the care our patients receive. And, everyone is treated with kindness and respect in our welcoming environment.

      This Position Will Offer You:

      • Engaging and community focused culture
      • Competitive Salaries
      • Opportunity for professional career growth
      • Robust benefits including: Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social and sporting events

      ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

      #CA *CA #LI-CJ #LI

  • About the company

      ProHealth Care offers a network of more than 700 physicians. Together they work in innovative ways to deliver excellent care and an outstanding patient experience. ProHealth’s hallmark services include cancer, heart and vascular care and orthopedic...

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