…off to the outpatient setting. The role integrates and coordinates utilization management concepts, care facilitations, and discharge planning functions. The Case

…and federal programmatic requirements, rules, and regulations. Assesses quality and utilization of services and resources by: + Forecasting future programs needs

…to help patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and right to

…for all EHC operating units, coordinating room assignments to optimize bed utilization across the health system, critically thinking to manage appropriate patient

…team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or

…billing activities, and patient interactions. Generating reports on financial assistance utilization , reimbursement trends, and other key metrics for management

…throughput while supporting a balance of optimal care and appropriate resource utilization . + Identify potential cause(s) of delayed wound healing. + Review

…planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient

…care plans to maximize healthcare outcomes and facilitate wellness with periodic review and update according to department protocols. + Perform medication review

…clinical competency and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond to patient/family complaints