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Medix is currently hiring for an Inpatient Nurse Case Manager at a hospital that is a national leader in weaning chronically critically ill patients from mechanical ventilation. Either a Registered Nurse (RN) or Licensed Vocational Nurse (LVN), is responsible for reviewing patient admissions and ongoing hospital stays to ensure they are medically necessary and appropriate and obtain Insurance authorization. This position is fully onsite at the hospital.
Schedule - Monday - Friday 8a-5p or 4 10's
Job Summary
This role involves assessing patient records, coordinating with healthcare providers, and adhering to regulatory guidelines to secure authorization from insurance for continued inpatient care at the Hospital. The nurse must evaluate the clinical information against established criteria and communicate effectively with third-party payers to obtain necessary insurance approvals. They will seek guidance from physicians and the utilization management team to ensure optimal patient outcomes. Prior experience in obtaining ongoing authorization is required, along with strong clinical judgment, excellent communication skills, and knowledge of healthcare regulations.
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