Registered Nurse Case Manager (RN) - Case Management

Conifer Health Solutions•San Antonio, TX

20d

About The Position

This position may qualify for a sign-on bonus 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

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
Accredited Case Management (ACM)

Nice To Haves

Bachelors or Master's Degree in Nursing

Responsibilities

facilitate care along a continuum through effective resource coordination
help patient achieve optimal health
ensure access to care and appropriate utilization of resources
ensure 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