Registered Nurse Case Manager Full Time Days

Valley Baptist Medical Center • Harlingen, TX

95d

About The Position

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.

Responsibilities

• Facilitate care along a continuum through effective resource coordination.
• Help patients achieve optimal health and access to care.
• Ensure appropriate utilization of resources while respecting patient self-determination.
• Assess patients for transition needs to promote timely throughput and safe discharge.
• Prevent avoidable readmissions.
• Integrate national standards for case management scope of services.
• Support medical necessity and denial prevention through Utilization Management.
• Promote appropriate length of stay and patient satisfaction through Transition Management.
• Demonstrate throughput efficiency in Care Coordination.
• Ensure compliance with state and federal regulatory requirements and accreditation standards.
• Provide education to physicians, patients, families, and caregivers.

Benefits

• Sign-on bonus

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals