Registered Nurse Case Manager II (RN)

Conifer Health Solutions • San Antonio, TX

2d

About The Position

This position is responsible for facilitating 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 role 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. The position integrates 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; Care Coordination by demonstrating efficient throughput while assuring care is sequenced and at the appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; and Education provided to physicians, patients, families, and caregivers. Completes established competencies for the position within the 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.
• Current Texas State license for Registered Nurse
• CPR certification

Nice To Haves

• Bachelors or Masters Degree in Nursing
• Previous Case Management Supervisory experience.
• Accredited Case Management (ACM)

Responsibilities

• Facilitate care along a continuum through effective resource coordination.
• Ensure care is provided at the appropriate level of care based on medical necessity.
• Assess patients for transition needs to provide timely throughput, safe discharge, and prevent avoidable readmissions.
• Integrate national standards for care management scope of services.
• Provide education to physicians, patients, families, and caregivers.
• Complete established competencies for the position within the designated introductory period.

Benefits

• Sign-on bonus

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED