2 Ccm jobs in the United Arab Emirates

Case Coordinator Nurse-Case Management

Abu Dhabi, Abu Dhabi Sheikh Shakhbout Medical City - SSMC

Posted 7 days ago

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Job Description

JOB DESCRIPTION
This position will coordinate with the multidisciplinary team and any other appropriate and accredited healthcare provider in the provision of quality patient care, under the guidance and supervision of the Senior Case Coordinator. The case coordinator will coordinate appropriate providers and access appropriate services to progress the patient’s episode of care in a timely manner.
RESPONSIBILITIES
  • Maintains active communication with physicians, nursing, and other appropriate members of the multidisciplinary team for the appropriate patient care management.
  • Participates in regular communication and feedback with Senior Case Coordinator.
  • Manages evidence-Based Medical Necessary screening criteria in support of admission and continued stay reviews and communicates with payers as necessary
  • Determines Correct Level of care placement- utilization management
  • Provides accurate medical documentation and health insurance documentation
  • Facilitates resource utilization- ensuring the available funding meets the clinical needs
  • Acts as a liaison between clinician and revenue department
  • Identifies and resolves variances to clinical pathways and obstacles to discharge.
  • Consults from appropriate disciplines/departments as required expediting care and facilitating discharge.
  • Ensures patient care is rendered to the maximum stipulation based on the patient’s benefits under the Insurance contract without exceeding the providers’ provision for the cost of care
  • Monitors and intervening as necessary to achieve desired goals and outcomes for both the patient and the hospital
  • Assesses and intervenes to address psychosocial needs including patient, family and community and collaborates with social workers as appropriate
  • Supports physicians in relation to Clinical Documentation impacting Medical Necessity, Case Mix Index, and Severity of Illness
  • Monitors length of stay and resource use on an ongoing basis and discusses trends with Senior Case Manager
  • Assists in the collection and reporting of indicators including LOS, excess days, resource utilization, and readmission rates.
  • Acts as a patient advocate in facilitating education based on identified learning needs of the patient and/or those providing care and documents appropriately
Accountabilities:
Monitors the patient’s progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient-focused, quality efficient, and cost-effective.
Plans utilization of resources and ensures the available funding meets the clinical needs
Facilitates along the Continuum of Care, monitoring against Clinical Pathway, and facilitation of transition plans
Ensures proactive discharge planning
QUALIFICATIONS
Educational Qualification:
Required:
Bachelor’s Degree in Nursing
Degree in Nursing (minimum two (2) years course duration) and Registration as a Registered Nurse from Canada, USA, UK, Ireland, South Africa, New Zealand, and Australia
Valid/Current national license.
BLS
Desired:
N.A.
Required:
Specialist Certifications:
Case Management Certification
Experience:
Required:
6 years’ experience in SSMC as staff nurse
OR
6 years of experience of which not less than 2 years in Case Management in a similar health care facility
Desired:
Experience in Large Healthcare facility
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Nursing Case Coordinator-SKMC-Case Management

Abu Dhabi, Abu Dhabi Abu Dhabi Health Services

Posted today

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Job Description

Description

The role of the new entrant Case Coordinator is to coordinate the multidisciplinary team and any other appropriate and accredited healthcare provider in the provision of quality patient care under the guidance and supervision of the Senior Case Coordinator.

ResponsibilitiesManagerial

The role includes advocacy & education, facilitation, transition & financial management, outcomes & psychosocial management to promote quality, safe, and timely transition through the healthcare system.

Under supervision and guidance from the Senior Case Coordinator, the case coordinator will coordinate appropriate providers and access services to progress the patient's episode of care in a timely manner.

Until competency is achieved as per evaluation, the Case Manager will develop patient care plans including:

  • Correct Level of care placement - Utilization Management
  • Care Facilitation along the Continuum of Care, monitoring against Clinical Pathway, and transition plans
  • Proactive Discharge Planning
  • Facilitation of accurate medical and insurance documentation
  • Resource Utilization, ensuring funding meets clinical needs
  • Linking physicians with finance
Technical

Participate in communication and feedback with Senior Case Coordinator. Apply appropriate Evidence-Based Medical Necessary screening criteria for admission and stay reviews, communicating with payers as needed.

Coordinate/delegate to multidisciplinary team to ensure patient care progression, working collaboratively with physicians, nursing, and other team members to ensure timely and appropriate management.

Understand patient benefits under insurance contracts to maximize care within cost constraints and collaborate to obtain necessary documentation.

Monitor patient progress, consult with Senior Case Coordinators, and intervene as necessary to ensure quality, efficient, and patient-focused care.

Facilitate advocacy, transition management, psychosocial needs assessment, and communication with financial managers. Complete documentation, obtain releases, and perform case management and quality screening.

Quality & Safety

Participate in performance improvement activities, collect and report indicators, analyze data, and support quality assurance programs. Assist in developing CQI processes and participate in projects related to clinical pathways, quality tools, and data analysis.

Support physicians regarding clinical documentation, medical necessity, case mix, and severity of illness. Educate and counsel patients and families, staying updated on professional practice developments.

Qualifications

Criteria for submission

Qualifications:

  • Bachelor degree in Nursing OR
  • Associate degree in Nursing from Canada or USA (minimum 2 years) AND
  • Successful completion of the National exam (NCLEX - RN for USA, Provincial Licensing Exam for Canada) OR
  • Diploma in Nursing and Midwifery (minimum 3.5 years) OR
  • Diploma in Nursing (minimum 3 years)

Experience:

  • Charge Nurse experience (2 years) in Case Management OR
  • Staff Nurse experience (4 years) in Case Management OR
  • Current SEHA Senior Charge Nurse, Charge Nurse, or Staff Nurse with completed SEHA Case Management Training Program (for current SEHA employees only)

Desired:

  • Experience in large healthcare facilities

Specialist Certifications:

  • Required: Case Management Certification from an international accreditation body (e.g., ANCC, ACMA, CMSA, AACM) for external hiring
  • Desired: Same certification for existing staff and internal hiring

If you meet the requirements, please email your Employee ID and updated CV to Mariam Ali Al Jaberi at the Recruitment Section.

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