Registered Nurse Case Manager (RN)

Conifer Health SolutionsSan Antonio, TX
9d

About The Position

Description Summary: 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; Care Coordination by demonstrating efficient throughput while assuring care is sequenced 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. Completes established competencies for the position within designated introductory period. Other related duties as assigned Qualifications MINIMUM EDUCATION: Graduate of an accredited School of Nursing PREFERRED EDUCATION: Bachelors or Masters Degree in Nursing MINIMUM EXPERIENCE: 2 years acute hospital patient care experience. Utilization/case management experience. PREFERRED EXPERIENCE: Previous Case Management Supervisory experience. REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State license for Registered Nurse PREFERRED CERTIFICATIONS/LICENSURE: Accredited Case Management (ACM) #LI-RR1 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

Requirements

  • Graduate of an accredited School of Nursing
  • 2 years acute hospital patient care experience
  • Utilization/case management experience
  • Possession of current Texas State license for Registered Nurse

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
  • help patient achieve optimal health
  • access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination
  • ensuring that care is provided at the appropriate level of care based on medical necessity
  • assess the patient for transition needs to provide timely throughput, safe discharge and prevent avoidable readmissions
  • 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 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
  • Completes established competencies for the position within designated introductory period
  • Other related duties as assigned

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

5,001-10,000 employees

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