Registered Nurse Case Manager II (RN)
About The Position
Responsible to facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination. 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 provide timely throughput, safe discharge and prevent avoidable readmissions. Integrates the national standards for care 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; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patients, families and caregivers; Provides education programs for Case Management Department on community resources used in discharge planning; Provides reports to DCM and hospital leadership as requested; Team Leader for discharge planning unit, providing guidance and monitoring.. Completes established competencies for the position within designated introductory period. Other related duties as assigned
Requirements
- Graduate of an accredited School of Nursing
- 2 years acute hospital patient care experience
- Utilization/case management experience
- 1 year supervisory experience
- Demonstrates computer knowledge of programs related to position and displays competency on an ongoing basis
- Possession of current Texas State license for Registered Nurse or LMSW/LCSW
Nice To Haves
- Bachelors or Masters Degree in Nursing
- Previous Case Management Supervisory experience
- Certification in Case Management (CCM, ACM)
Responsibilities
- Facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination
- Ensure that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to provide timely throughput, safe discharge and prevent avoidable readmissions
- Integrate the national standards for care management scope of services including: Utilization Management supporting medical necessity and denial prevention
- Integrate the national standards for care management scope of services including: Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
- Integrate the national standards for care management scope of services including: Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
- Provide education to physicians, patients, families and caregivers
- Provide education programs for Case Management Department on community resources used in discharge planning
- Provide reports to DCM and hospital leadership as requested
- Act as Team Leader for discharge planning unit, providing guidance and monitoring
- Complete established competencies for the position within designated introductory period
- Perform other related duties as assigned
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What This Job Offers
Career Level
Manager
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
