Case Manager

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Promote quality and cost-effective interventions and outcomes

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Record cases information, complete accurately all necessary forms and produce statistical reports

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Develop effective working relations and provide feedback to administrative, medical, and RCM team throughout the entire case management process

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Handling case assignments, draft service plans, review case progress and determine case closures

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Evaluating healthcare treatments and negotiating the most cost effective options available to manage DRG

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Assist in timely discharge

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Evaluate the rigor of documentation and code assignment (during IP stay with doctors) to ensure fair remuneration

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Evaluate and develop training sections to avoid rejections

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Rejection analysis, management and coordination with responsible departments in developing collaborative strategies.

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Audit files and alert vulnerabilities with concerned departments.

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All other duties and responsibilities assigned by hospital administrator.

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Comply with all OSH (Occupational safety and health )and infection control policies, standards and procedures and cooperate with hospital management to comply those requirements

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Work accordance with the documented OSH procedures and instructions, specific responsibilities

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Be familiar with emergency and evacuation procedures

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Notifying OSH Hazards, incidents, Near misses and issues and assistance with the preparation of risk assessments, incident reports

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Comply with Waste management procedures and policies

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Attend applicable OSH/Infection control training programs, mock drills and awareness programs

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Use of appropriate personal protective equipment and safety systems

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Ensure as far as reasonably practicable that any workplaces they manage or control are safe and without risks to health, safety or the environment.

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Ensure implementation of applicable HAAD, NMCSH OSHMS and infection control policies and standards

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Ensure adequate budget and resources for FMS/OSH/PCI management.

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Designating a Safety facilitator who will be responsible for coordinating OSH activities within the department.

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Regularly discuss OSH issues or matters in departmental/ management meetings

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Ensure provision of OSH information, training and Supervision

• Implement and monitor effectiveness of risk management program.

-

Promote quality and cost-effective interventions and outcomes.

-

Record case information, complete all necessary forms accurately and prepare statistical reports.

-

Develop effective working relationships and provide feedback to administrative, medical and RCM teams throughout the entire case management process.

-

Handle case assignments, draft service plans, review case progress and determine case closures.

-

Evaluate healthcare treatments and negotiate the most cost-effective options available to manage DRG.

-

Assist in timely patient discharge.

-

Evaluate the accuracy and completeness of documentation and code assignment during inpatient stays, in coordination with doctors, to ensure fair remuneration.

-

Evaluate and develop training sessions to avoid rejections.

-

Analyse and manage rejections and coordinate with responsible departments to develop collaborative strategies.

-

Audit files and highlight vulnerabilities to the concerned departments.

-

Perform all other duties and responsibilities assigned by the Hospital Administrator.

-

Comply with all OSH (Occupational Safety and Health) and infection control policies, standards and procedures, and cooperate with hospital management to meet these requirements.

-

Work in accordance with documented OSH procedures, instructions and specific responsibilities.

-

Be familiar with emergency and evacuation procedures.

-

Notify OSH of hazards, incidents, near misses and issues, and assist with the preparation of risk assessments and incident reports.

-

Comply with waste management procedures and policies.

-

Attend applicable OSH/infection control training programmes, mock drills and awareness programmes.

-

Use appropriate personal protective equipment and safety systems.

-

Ensure, as far as reasonably practicable, that workplaces under their management or control are safe and free from risks to health, safety and the environment.

-

Ensure implementation of applicable HAAD, NMCSH OSHMS and infection control policies and standards.

-

Ensure adequate budget and resources for FMS/OSH/PCI management.

-

Designate a Safety Facilitator responsible for coordinating OSH activities within the department.

-

Regularly discuss OSH issues and matters in departmental/management meetings.

-

Ensure the provision of OSH information, training and supervision.

-

Implement and monitor the effectiveness of the risk management programme.

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Sound clinical training and background.

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Medical/Allied Health graduate.

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Sound knowledge of coding, billing, auditing, approvals and clinical practices.

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Relevant coding certification.

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Auditing certification/training is preferred.

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Minimum 5 years of clinical experience in a hospital.

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1–2 years of supervisory experience.