Emergency Department Case Management (Navigators)
Collaboratively Coordinating care and facilitating clinical management and discharge needs for patients accessing care thru the Emergency Department; participating in innovative patient care projects such as texting as a communication tool post discharge.
Inpatient Case Management (Navigators)
Coordinating care and collaboratively facilitating clinical management for patients across the continuum of care.
Integrated Call Center (ICC)
Serving as a centralized resource for consumers, to receive symptom triaging, and by providing appropriate, streamlined access to the organization’s faculty, staff, and clinical services via phone and/or Web, MyChart, ACO.
Level of Care
Collaborating with UIHC providers to identify medical necessity and level of care.
RAC (Recovery Audit Contractor reviews)
Support the clinical enterprise by clinical review of external case denials and preparing documentation for appeal of medical necessity.
Utilization Management (UM)
Obtaining precertification for inpatient admissions, providing payers with clinical continued stay reviews via a variety of communication modes (telephone, faxing, electronic submission), responding to and appealing denied cases.