To Get it Right Up Front, You Have to Be Up Front.

Emergency department case managers are essential to prevent payer denials by ensuring that patient status and level of care is correct; prevent admissions and readmissions by linking patients to community services; improve patient throughput by ensuring that tests are procedures are conducted in a timely manner; and to facilitate hospice and palliative care referrals. Case managers should cover the ED seven days a week during the hours when the volume is highest. Hospitals with a lot of payers that require preauthorization, or a large volume of complex patients, or those with behavioral disorders may need 24-hour coverage. EDs also need social workers on hand to coordinate community services, facilitate mental health referrals, and handle issues such as abuse, neglect, domestic violence, and chemical dependence. The best candidates for ED case management positions are experienced case managers with a high level of clinical knowledge, good organizational skills, and the ability to work quickly.