Case Manager - NICU
Odessa Regional Medical Center was founded in 1975 by 14 obstetricians, pediatricians, and family practitioners as Odessa Women’s and Children’s Hospital. Through the years, the hospital grew and evolved into a full-service healthcare facility and the name was changed to Odessa Regional Hospital in 1995.
In June 2007, Odessa Regional Hospital purchased Alliance Hospital and changed its name to Odessa Regional Medical Center to reflect its larger campus and more comprehensive services. In 2015, ORMC acquired Basin Healthcare Center. The hospital has 225 beds and has approximately 250 physicians on staff and has over 700 employees.
Today, ORMC offers a wide spectrum of healthcare services, including advanced diagnostic imaging technology, emergency care, innovative surgical procedures, maternity care, comprehensive cardiac services and general medical care.
About the Position:
The Case Manager will assume primary responsibility of cases for documentation of appropriate medical necessity for the inpatient or observation status. Communicates with physician, ancillary staff, and payers and assists in arranging transfers or alternate placement when indicated. Assure proper level of care assignment. Facilitates with Case Managers and other allied health professionals to promote and ensure that quality care is provided and outcomes are achieved in a timely and cost-effective manner. Utilizes a complete and systematic methodology/process to assess, plan, implement, evaluate and provide patient care coordination for patients from pre-hospital through post-hospital aftercare. Assist in the development of physician profiles to identify over/under utilization patterns. Promote appropriate post-hospital utilization of resources, adequate education of patient and hospital staff, and decreased incidence of re-admissions. Support hospital goals and objectives in compliance with regulatory guidelines. The Case Manager will work in collaboration with all healthcare disciplines to assure a continuum of appropriate and timely services. to assess the medical appropriateness, quality, and cost-effectiveness of proposed hospital, medical, and surgical services in accordance with established criteria. Collaborate with the multidisciplinary team to assist patient with benefits resource management, evaluating appropriateness of the level of care, and communicating with the payer to obtain authorization. Identifies and plans strategies to reduce inpatient length of stay and resource consumption.