Registered Nurse Case Manager (RN)

1 day ago Be among the first 25 applicants Overview The RN Case Manager facilitates care along a continuum through effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual has overall responsibility for ensuring care is provided at the appropriate level based on medical necessity and to assess transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions. This role integrates national standards for case management including utilization management, transition management, care coordination, compliance with regulatory requirements, TJC accreditation standards, and Tenet policy. Education is provided to physicians, patients, families, and caregivers. Education Required: Graduate of an accredited school of nursing Preferred: Academic degree in nursing (bachelor\'s or master\'s) Experience Required: 2 years of acute hospital patient care experience Preferred: Acute hospital case management experience Certifications Required: RN; active license to practice in state(s) covered Preferred: Accredited Case Manager (ACM); BLS The Individual’s Responsibilities Include The Following Activities Accurate medical necessity screening and submission for Physician Advisor review Care coordination Transition planning assessment and reassessment Implementation or oversight of the transition plan Leading and facilitating multi-disciplinary patient care conferences Managing concurrent disputes Making appropriate referrals to other departments Identifying and referring complex patients to Social Work Services Communicating with patients and families about the plan of care Collaborating with physicians, office staff, and ancillary departments Leading and facilitating Complex Case Review Ensuring patient education is completed to support post-acute needs Timely, complete, and concise documentation in Case Management system Maintenance of accurate patient demographic and insurance information Identification and documentation of potentially avoidable days Identification and reporting over- and underutilization Other duties as assigned Seniority level Associate Employment type Temporary Job function Health Care Provider Industries Hospitals and Health Care and Medical Practices Employment practices will not be influenced 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 undue hardship. Tenet complies with federal, state, and local laws regarding mandatory vaccination of its workforce. If offered this position and required to be vaccinated, you will need to show proof of full vaccination or obtain an exemption and may be subject to regular testing if exempt. #J-18808-Ljbffr Valley Baptist Health System