RN-Case Manager - BMH Desoto

RN-Case Manager - BMH Desoto at Baptist Memorial Health summary:
The RN-Case Manager at BMH Desoto oversees patient care management, ensuring safe transitions throughout the continuum of care while optimizing resource utilization and complying with payer and federal regulations. Responsibilities include utilization review, discharge planning, readmission reduction, and payer communication to reduce denials. This role requires an active RN license and experience in clinical case management within hospital or payer settings, with strong critical thinking and communication skills.
Summary
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities

• Utilization Review

• Discharge planning

• Readmission Reduction Participation

• Payer Communication and denial reduction

• Completes assigned goals.
Requirements, Preferences and Experience
Education
Preferred : BSN or MSN
Minimum :
Diploma or Associate Degree in Nursing
Experience
Preferred : RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Minimum : RN with at least one (1) year of clinical experience
Licensure, Registration, Certification
Preferred : RN;

CCM;

ACM
Minimum : RN
Special Skills
Preferred :
Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Minimum :
Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Training
Preferred :
Certified Case Manager
About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups.

Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We

Offer:

• Competitive salaries

• Paid vacation/time off

• Continuing education opportunities

• Generous retirement plan

• Health insurance, including dental and vision

• Sick leave

• Service awards

• Free parking

• Short-term disability

• Life insurance

• Health care and dependent care spending accounts

• Education assistance/continuing education

• Employee referral program

Job Summary:

Position:

RN-Case Manager
Facility: BMH - Desoto Hospital
Department: DC Case Management Admin BMH Desoto
Category:
Nurse RN
Type:
Clinical
Work Type:
Full Time

Work Schedule:

Days

Location:

US:

MS:

Southaven
Located in the Memphis metro area
Keywords:
RN Case Manager, patient care management, utilization review, discharge planning, readmission reduction, payer communication, clinical nursing, case management, healthcare compliance, transitional care