The Care Manager, will assess, plan, implement and evaluate the options and services required to meet an individual’s health needs during the acute encounter. Experience in continuing care planning, resource management, medical necessity or care management desired. Knowledge of payers, reimbursement, DRGs and ACO desired. Revenue integrity and compliance knowledge– Screening for medical necessity and working with Physician Advisor for secondary reviews-utilization review and utilization management. Knowledge of various levels of care including home care and all types of nursing facilities. Knowledge of CMS Conditions of Participation pertaining to Care Management and Utilization Management.
Eastern Maine Medical Center
Bangor, ME 04401