Registered Nurse (RN) - Case Management
Role Overview
The RN Case Manager is responsible to facilitate 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 in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: • Utilization Management supporting medical necessity and denial prevention • Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction • Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care • Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy • Education provided to physicians, patients, families, and caregivers
Full Job Posting
SUMMARY:
The RN Case Manager is responsible to facilitate 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 in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: • Utilization Management supporting medical necessity and denial prevention • Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction • Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care • Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy • Education provided to physicians, patients, families, and caregivers
Qualifications
- 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.
- LICENSE/CERTIFICATION: Required: RN. Must be currently licensed, certified, or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered. Preferred: Accredited Case Manager (ACM)
- #LI-RS1
- Required: Graduate of an accredited school of nursing.
- Required: 2 years of acute hospital patient care experience.
- Required: RN. Must be currently licensed, certified, or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.
Preferred Qualifications
- Preferred: Academic degree in nursing (bachelor's or master's)
- Preferred: Acute hospital case management experience.
- Preferred: Accredited Case Manager (ACM)
About Conifer Health Solutions
Diversified healthcare services company operating hospitals and outpatient centers.
Visit company websiteApply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at Conifer Health Solutions
Regional Vice President, Operations II, USPI – Dallas, TX
Dallas, USA
Step Down Registered Nurse Fulltime Nights
Sunnyvale, USA
Step Down Registered Nurse Fulltime Days
Sunnyvale, USA
Associate Administrator DMC Children’s Hospital
Detroit, USA
Regional Vice President, Operations II, USPI – Dallas, TX
Dallas, USA
Patient Access Representative ED
, USA
Patient Access Representative II
Phoenix, USA
PSC Pre Auth Representative - Remote
, USA
Anesthesia Tech
West Palm Beach, USA