Case Manager RN Virtual Care

UT Health East Texas•Athens, TX

About The Position

Join our team as a day shift, full-time, Acute Care Case Manager Registered Nurse (RN) in Athens, TX. Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: UT Health Athens is a 127-bed facility, including a 24-hour ED, designated as a Level IV trauma center and Level III stroke center; advanced diagnostic technology; 10-bed ICU; maternity unit radiation therapy center; and a stand-alone ED in Gun Barrel City.

Requirements

Associates degree in nursing or higher
Competent with Medical Necessity Review criteria

Nice To Haves

Two (2) years acute hospital-based case management experience

Responsibilities

The Virtual Case Management Admission Review Nurse has overall responsibility for ongoing clinical review of patient medical record as they are identified as needing hospitalization.
This would include working directly with medical care providers to determine the appropriate level of care assignment based on CMS (Centers for Medicare and Medicaid Services) requirements.
This may include the use of medical necessity guidance tools to assist with assignment of the appropriate level of care.
Coordination and communication will occur with members of the local Case Management team and market Utilization Review team.