Company Info
Children's Hospital Colorado

Aurora, CO, United States

Phone: 720-777-1234
Web Site:

Company Profile

Case Manager Ambulatory



Case Manager


Case Manager Ambulatory


Aurora, CO, United States 

Zip Code:


Employment Type:

Full time

# of Beds:


Job Requirements:

General Work Experience: Minimum of 3 years experience in a pediatric setting is required with Inpatient and Case Management/Utilization Management experiences preferred. Knowledge of case management, utilization management and assessment tools is preferred. Excellent leadership and interpersonal problem solving skills. Ability to work with a wide variety of clinical personnel required. Strong knowledge of discharge planning and community resources necessary. Excellent verbal, written, and phone skills. Ability to meet deadlines and work under pressure. Knowledge of personal computer, including word processing, spreadsheet applications, and other communication software (e-mail). Required Education/Field of Study: Graduate of an accredited college or university with a Bachelor of Science, which may be waived in lieu of enrollment in an accredited BSN program within one year of accepting the position and BSN degree completion within a period of three years. Required License/Certification - Registered Nurse

Job Description:

The Case Manager provides assessment, planning, facilitation, and advocacy for optimal clinical and financial outcomes. The Case Manager collaborates with the patient, family, other healthcare team members, community providers, and community resources and payors, resulting in an appropriate level of care, placement, length of stay, follow up care and reimbursement. The case manager assists with the appropriate use of resources both within the facility and external to the facility. Communication and collaboration may include coordinating admissions with referring facilities and providers, utilization review, discharge planning, transportation and care coordination. The case manager may also provide services in variety of ambulatory clinic settings. Utilization Management encompasses all inpatient units, including network of care sites, as well as outpatient programs for the Eating Disorder Unit and Adolescent/Child Psychiatric Unit (partial hospitalization, day treatment, and intensive outpatient) and includes review of medical necessity for the level of care and ongoing services. Electronic Clinical Documentation is utilized to document and communicate the plan of care with the patient, family, and health care team. The case manager may also be involved with other services including, but not limited to: denial management with investigation and appeal letters to insurance companies; collaboration with Managed Care, Insurance Verification, Financial Counseling, Patient Financial Services, and Health Information Management; data aggregation and analysis related to caseload, length of stay, outlier days, avoidable days, and denials overturned or upheld; education and case management orientation for RNs, residents, physicians, students, and other departments; and durable medical equipment functions.

Job ID: