Job Title: Case Manager
Location: Sitka, Alaska
Schedule: 8:00AM – 4:00PM x 5
Term: 13-week assignment with the potential for extension
Pay Rate: $77 – $83/hr
Astrya Global, a San Diego based medical staffing agency, is hiring a Case Manager for a temporary assignment in Sitka, Alaska. These positions are 13-week contracts with the ability to extend.
Responsibilities for a Case Manager:
• Review patients’ records and evaluate patient progress
• Perform continuing review of patient hospitalization to monitor necessity and appropriateness of hospitalization, length of stay, and quality of care
• Provide Utilization Management (UM) and review functions to the Purchased/Referred Care Services program for beneficiary patients admitted to other facilities
• Obtain and review necessary medical reports and treatment plans as requested by regulatory agencies or payers
• Review and validate physician orders, report progress and unusual occurrences on patients
• Collaborate with physicians and clinical care team to ensure healthcare services are appropriate and cost-effective
• Collaborate with physicians and clinical care team to ensure adherence to the UM/CM/DCP plan
• Review new hospital admissions to assess patient conditions and needs in order to develop personalized treatment plans
• Provide appropriate or required information to patients and/or their families regarding their healthcare benefits
• Participate in interdisciplinary collaboration with professional staff
• Ensure maintenance of the Utilization Review Plan in collaboration with the Utilization Review staff and Medical Director
• Facilitate educational programs and advise physicians and other departments of regulations affecting UM/CM/DCP
• Direct coordination of patient care departments, ensuring treatment plans are based on patient need and meet criteria approved by regulatory or payer requirements
• Ensure documentation supports UM functions and communicate with payers within required timeframes
• Review information, communicate results to claims adjusters, and enter billing information appropriately
• Prepare information for notification letters to providers, staff, and patients
• Receive and process requests for appeal of denials
• Respond to complaints per UM review guidelines
• Maintain utilization review and appeal logs
• Support clinical improvement activities by providing quality review
• Perform tumor registry functions
• Maintain active Alaska nursing license at time of submission
• Comply with flu vaccine requirement
• Complete fingerprinting process within required timeframes upon acceptance
Benefits for a Case Manager:
- Weekly pay every Friday
- Medical/Dental/Vision/Life/Pet Insurance
- 401K Retirement Plan (matching)
- Full-service Credentialing and Corporate Travel Team
- Referral Bonus up to $1,500
Astrya Global Medical Staffing offers 10+ years of staffing experience, 100% domestic support, and is certified by both the Joint Commission and National Association of Locum Tenens Organizations. At Astrya, we are dedicated to helping healthcare professionals find the perfect job.