Page 118 - CHHA Binder 2.3.20

4/11/2019

The Five Most Critical Action Steps For Preventing
Readmissions For All Patients

Addressing these at SOC have the greatest impact in preventing
readmissions! 11

ROLE OF CLINICAL UTILIZATION MANAGER

Clinical Utilization Managers/Care Managers :

 Guide and support CHHA clinicians in the delivery of care and
support for Managed Care and Case Rate patients
 Promote optimal utilization by ensuring the right care at the right time
 Collaborate with field clinician/CFM at beginning of CHHA episode
 Provide utilization and care guidance during CHHA episode
 Manage patients post-CHHA for 60-day period (Including community
providers)
 Provide authorization for services to the Managed Care and Case
Rate population

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