Registered Nurse (RN) - Case Manager

Registered Nurse (RN) – Case Manager Join our dedicated healthcare team where compassion meets innovation. As a Registered Nurse with us, you will make a meaningful impact in patients’ lives while working in a supportive environment that fosters professional growth and work‑life balance. Benefits Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match Generous paid time off (PTO) Career development and continuing education opportunities Health savings accounts, healthcare and dependent flexible spending accounts Employee assistance and discount programs Voluntary benefits: pet insurance, legal insurance, accident and critical illness insurance, long‑term care, elder and childcare, auto and home insurance Eligibility for benefits may vary by location and is determined by employment status. Job Responsibilities Facilitate care along a continuum through effective resource coordination; ensure care is provided at the appropriate level based on medical necessity. Screen for medical necessity and submit for physician advisor review. Coordinate care, including transition planning and assessment. Implement or oversee transition plans and ensure timely completion. Lead multi‑disciplinary patient care conferences and complex case reviews. Manage concurrent disputes and make appropriate referrals to other departments. Identify and refer complex patients to social work services. Communicate with patients and families about the plan of care. Collaborate with physicians, office staff, and ancillary departments. Ensure patient education is completed to support post‑acute needs. Maintain accurate patient demographic and insurance information. Document in the case management system and identify avoidable days. Report over‑ and under‑utilization. Perform other duties as assigned. Specialized Responsibilities Utilization Management – balance clinical and financial requirements, advocate for patients, secure appropriate payment from payers, and prevent denials and disputes. Transition Management – assess patients within 24 hours of admission, develop and implement transition plans, identify readmission risk, and ensure plans are completed accurately. Care Coordination – screen patients for factors affecting progression, conduct risk assessments, ensure appropriate sequencing of tests and procedures, and collaborate with the healthcare team for timely throughput. Education – provide education to patients, physicians, and the healthcare team on progression of care, appropriate level of care, and safe transitions. Compliance – ensure adherence to federal, state, and local regulations, accreditation requirements, and Tenet policies; remain current with case management practices. Qualifications Graduate from an accredited school of nursing; bachelor’s degree in nursing or related field, or equivalent education and experience. Two years of acute hospital patient care experience; acute hospital case management experience preferred. Licensed as a Registered Nurse in the State of Michigan. Accredited Case Manager (ACM) preferred. Complete Tenet’s InterQual education course within 30 days of hire (and at least annually) with a score of 85 or better. Demonstrate competency in using the Tenet Case Management documentation system within 30 days of hire. Attend hospital and department orientation covering case management policies, InterQual, transition management, utilization management, and related topics. Facility DMC Detroit Receiving Hospital – Michigan’s first Level I Trauma Center, with the state’s leading 24/7 hyperbaric oxygen program, Metro Detroit’s first certified primary stroke center, and the nationally recognized DMC Rosa Parks Geriatric Center of Excellence. EEO Statement Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E‑Verify program. #J-18808-Ljbffr Tenet Healthcare