Case Manager

DUTIES AND RESPONSIBILITIES Promote quality and cost-effective interventions and outcomes. Record case information, complete accurately all necessary forms and produce statistical reports. Develop effective working relations and provide feedback to administrative, medical, and RCM team throughout the entire case management process. Advise healthcare providers on correct documentation, optimal resource utilization and controlling outlier expenses. Promote correct completion of documentation to ensure correct E&M coding, correct CMI calculation and DRG severity levels. Advise departments on the optimal case mix. Ensure minimal leakages of potential revenue. Advise doctors on best practice trends. Evaluate and develop training sections to avoid rejections. Random file audits with regular feedback to concerned departments. OSH ROLES AND RESPONSIBLITIES : GENERAL: Responsible for implementation of OSHAD-SF& NMCSH Al Ain Internal OSHMS/ OSHMS /EHSMS policies and procedures/SOP’s relevant to their department. Should notify/report all OSHMS/EHSMS hazards, incidents, accidents and near misses within the premises of NMCSH Al Ain to their supervisor or department OSH Facilitator as per the incident reporting protocol of NMCSH Al Ain. Should familiarize them and comply with all NMCSH Al Ain OSHMS /EHSMS policies, standards and procedures that are relevant for their workplace. Responsible to attend applicable department OSHMS /EHSMS training and follow NMCSH Al Ain policies and procedures. Responsible for taking reasonable care for their health and safety of persons and the Occupational that may affect by the labor act or omissions at the workplace. Responsible to wear all PPE’s provided to them. Staff is not allowed to tamper or misuse any NMCSH Al Ain equipment’s and its property. Should abide all safety instructions and signages within the premises of NMCSH-Al Ain. Responsible for following and complying with any specified OSH/EHS procedures associated to the task/job. Specific: Lead the development of appropriate OSH management system. The ultimate responsibility for Occupational, Health and Safety within all facilities of NMCSH, Al Ain. Shall allocate adequate resources for OSH management ( e.g. Budget , human resources, equipment’s) The GM approves and endorses NMCSH, Al Ain EHSMS/OSH Policies and Procedures/Programs /Plan. Sets and approves a clear OSH Policy for NMCSH, Al Ain. Ensure that the OSH policy is reviewed annually Responsibilities DUTIES AND RESPONSIBILITIES Promote quality and cost-effective interventions and outcomes. Record case information, complete accurately all necessary forms and produce statistical reports. Develop effective working relations and provide feedback to administrative, medical, and RCM team throughout the entire case management process. Advise healthcare providers on correct documentation, optimal resource utilization and controlling outlier expenses. Promote correct completion of documentation to ensure correct E&M coding, correct CMI calculation and DRG severity levels. Advise departments on the optimal case mix. Ensure minimal leakages of potential revenue. Advise doctors on best practice trends. Evaluate and develop training sections to avoid rejections. Random file audits with regular feedback to concerned departments. OSH Roles and Responsibilities General Responsibilities: Responsible for implementation of OSHAD-SF and NMCSH Al Ain Internal OSHMS/EHSMS policies, procedures, and SOPs relevant to the department. Notify/report all OSHMS/EHSMS hazards, incidents, accidents, and near misses within NMCSH Al Ain premises to the supervisor or department OSH Facilitator as per the incident reporting protocol. Familiarize with and comply with all NMCSH Al Ain OSHMS/EHSMS policies, standards, and procedures relevant to the workplace. Attend applicable departmental OSHMS/EHSMS training and follow NMCSH Al Ain policies and procedures. Take reasonable care of personal health and safety and that of others who may be affected by acts or omissions at the workplace, in accordance with the labor act. Wear all provided PPE as required. Refrain from tampering with or misusing any NMCSH Al Ain equipment or property. Abide by all safety instructions and signage within NMCSH Al Ain premises. Follow and comply with any specified OSH/EHS procedures associated with assigned tasks or job responsibilities. Specific Responsibilities: Lead the development and implementation of an appropriate OSH Management System. Hold ultimate responsibility for Occupational Health and Safety across all NMCSH Al Ain facilities. Allocate adequate resources for OSH management (budget, human resources, and equipment). Approve and endorse NMCSH Al Ain EHSMS/OSH policies, procedures, programs, and plans. Set and approve a clear OSH Policy for NMCSH Al Ain and ensure annual review of the policy. Qualifications QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS Sound clinical training and background Medical or Allied Health graduate Strong knowledge of coding, billing, auditing, and clinical approvals International certification in medical coding Preferred auditing certification or relevant training Minimum 5 years of clinical experience in a hospital setting At least 2 years of supervisory experience