Case Manager, NMC Royal Hospital, Abu Dhabi, UAE
1. ORGANIZATIONAL STRUCTURE:
1.1 REPORT TO: Hospital Administrator
1.2 RESPONSIBLE FOR: Case management, Cost Interventions and outcomes, Timely discharge
1.3 LIAISES WITH: Colleagues and HODs
Physicians and specialist
Patients and Families
Others as related to the evaluation and care of patients
2. JOB SUMMARY:
Rejection analysis, management and coordination with responsible departments in developing collaborative strategies and promote quality and cost-effective interventions and outcomes.
3. DUTIES AND RESPONSIBILITIES:
3.1 Promote quality and cost-effective interventions and outcomes
3.2 Record cases information, complete accurately all necessary forms and produce statistical reports
3.3 Develop effective working relations and provide feedback to administrative, medical, and RCM team throughout the entire case management process
3.4 Handling case assignments, draft service plans, review case progress and determine case closures
3.5 Evaluating healthcare treatments and negotiating the most cost effective options available to manage DRG
3.6 Assist in timely discharge
3.7 Evaluate the rigor of documentation and code assignment (during IP stay with doctors) to ensure fair remuneration
3.8 Evaluate and develop training sections to avoid rejections
3.9 Rejection analysis, management and coordination with responsible departments in developing collaborative strategies.
3.10 Audit files and alert vulnerabilities with concerned departments.
3.11 All other duties and responsibilities assigned by hospital administrator.
3.12 Comply with all OSH (Occupational safety and health )and infection control policies, standards and procedures and cooperate with hospital management to comply those requirements
3.13 Work accordance with the documented OSH procedures and instructions, specific responsibilities
3.14 Be familiar with emergency and evacuation procedures
3.15 Notifying OSH Hazards, incidents, Near misses and issues and assistance with the preparation of risk assessments, incident reports
3.16 Comply with Waste management procedures and policies
3.17 Attend applicable OSH/Infection control training programs, mock drills and awareness programs
3.18 Use of appropriate personal protective equipment and safety systems
3.19 Ensure as far as reasonably practicable that any workplaces they manage or control are safe and without risks to health, safety or the environment.
3.20 Ensure implementation of applicable HAAD, NMCRH OSHMS and infection control policies and standards
3.21 Ensure adequate budget and resources for FMS/OSH/PCI management.
3.22 Designating a Safety facilitator who will be responsible for coordinating OSH activities within the department.
3.23 Regularly discuss OSH issues or matters in departmental/ management meetings
3.24 Ensure provision of OSH information, training and Supervision
3.25 Implement and monitor effectiveness of risk management program
4. QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS:
4.1 Sound clinical training and background.
4.2 Medical/ Allied Graduate.
4.3 Sound coding, Billing, Auditing approval and clinical known.
4.4 Certification coding.
4.5 Preferred auditing certification / Training.
4.6 Clinical experience of 5 year in hospital.
4.7 1-2 Year supervisory experience.
Primary Location: Royal Hospital - Khalifa City - Abudhabi
Work Locations: Royal Hospital - Khalifa City - Abudhabi Abu Dhabi Abu Dhabi
Job: Non Medical
Organization: NMC Royal Hospital KLF
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