Case Manager RN Utilization Review FT McAllen

UHS • McAllen, TX

4h • Onsite

About The Position

The RN Case Manager is responsible for managing resource utilization and clinical outcomes for patients, as well as addressing their discharge needs. The RN will also be involved in the denial management process. There may be instances where working weekends, holidays, evenings, nights, and/or on-call/call-back status is necessary. The role requires demonstrating Service Excellence standards at all times.

Requirements

• 1 year previous acute care RN experience required (within the last three years).
• Licensed in the State of Texas.
• Registered Nurse currently licensed in the State of Texas, or part of a compact state license, or has a valid temporary RN license for the State of Texas while waiting to receive the permanent license.
• Must possess an Associate Degree, Baccalaureate Degree or Diploma from a School of Nursing or University.
• Must demonstrate commitment and adherence to STHS’s Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.

Nice To Haves

• Bilingual preferred (Spanish).
• Experience in Health Care Coordination preferred.
• BSN preferred.

Responsibilities

• Manage resource utilization and clinical outcomes for patients.
• Address discharge needs of patients.
• Assist with the denial management process.
• Demonstrate Service Excellence standards at all times.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree