Registered Nurse Case Manager; RN

1 day ago Be among the first 25 applicants

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.

• Required:
  
  Graduate of an accredited school of nursing
• Preferred:
  Academic degree in nursing (bachelor s or master s)

• Required:
  
  2 years of acute hospital patient care experience
• Preferred:
  Acute hospital case management experience

• Required:
  
  RN; active license to practice in state(s) covered
• Preferred:
  Accredited Case Manager (ACM); BLS

• 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 under utilization
• Other duties as assigned

• Associate

• Temporary

• Health Care Provider

• 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.