Health Underwriting Manager jobs in Dothan, AL

The Case Manager II (CM II) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient's rehabilitation experience. The CM II coordinates and advocates for the patient during their hospitalization and from pre-admission to post-discharge. As an effective communicator, the CM II manages information to effectively oversee health care delivery and facilitate interdisciplinary plan of care decisions. The CM II facilitates timely communication regarding the patient's care, and establishes and monitors the discharge plan implementation while identifying and addressing patient's psychosocial and support systems issues. The Case Manager II oversees the effective coordination of services and manages issues in the following main areas: admission and discharge, team conference and interdisciplinary plan of care communication, patient and family education, payor relations, and total fiscal management. The CM II performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team. The case manager assures that regulations regarding patient's rights are fulfilled.
Job code: 101052
Qualifications
License or Certification:

• ACM or CCM certification is preferred, but not required for part-time case managers.

Minimum Qualifications:

• For Registered Nurses (RN):
• Must possess an Associate Degree in Nursing (ADN or ASN). Bachelor's degree (BSN) preferred.
• Must hold a valid, active, unencumbered license in the state where the hospital is located or from an appropriate Nursing Licensure Compact state.
• A diploma in nursing is acceptable only in those states whose minimum requirement for RN licensure is a diploma rather than an Associate Degree.
• For Eligible licensed or certified health care professionals other than nurses:
• Must possess a minimum of a bachelor's degree in a health-related field.
• If licensure is available within the state where the hospital is located and is applicable to the individual's educational level (i.e. BSW), the individual must hold a valid, active, unencumbered license.
• Inpatient rehabilitation experience preferred.

Machines, Equipment Used:

• General office equipment such as computer/laptop, telephone, copy/fax machine, calculator, scanner, etc.
• Microsoft Office software, to include Outlook, Word, and Excel.

Physical Requirements:

• Visual acuity, speech recognition, speech clarity.
• Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling exceeds these minimum requirements.

Skills and Abilities:

• Oral communication, written communication, fluency in English, active listening.
• Information ordering, deductive reasoning, social perceptiveness, time management, critical thinking.
• Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
• Ability to work independently without continuous supervision.

Environmental Conditions:

• Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure.
• Exposure or potential exposure to blood and body fluids may be required.
• Handicapped accessible.
• May work under stressful circumstances at times.

Proficiency or Productivity Standards:

• Has regular, reliable, and predictable attendance and punctuality.
• Adheres to dress code including wearing ID badge.
• Adheres to Standards of Business Conduct.
• May be required to work weekdays and/or weekends, evenings and/or night shifts if needed to meet deadlines.
• May be required to work on religious and/or legal holidays on scheduled days/shifts.
• Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster.
• May be required to perform other duties as assigned by supervisor.
• This position will support cultural diversity by promoting and maintaining an inclusive work environment and culture that is respectful and accepting of diversity.