The RN Case Manager provides ongoing support to Mayo Clinic Rochester and Mayo Clinic Health System medical practices with direct interaction with clinical staff in the hospital setting, including nursing, social workers, physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review, including concurrent admission status and continued stay clinical review; communication with clinical providers to identify quality value based purchasing core measures for hospital bedded patients. Clarification and face to face education to clinical staff regarding quality metrics, and continued admission status review to ensure accurate clinical documentation to support the care provided. This position requires strong independent decision making, assessment, and reasoning while determining the appropriateness of patient admission status following established admission criteria and regulations. This position requires knowledge, understanding, and continued education on current regulatory compliance requirements of Government Payers in relation to Admission Status, Clinical Documentation, and Value Based Purchasing. THE RN Case Manager communicates with physicians, patients, and other clinical staff regarding documentation, Quality, and Admission Status criteria and regulatory requirements and penalties. The RN CASE MANAGER works with Third-Party and Government payers to meet managed care and continued stay requirements. The RN Case Manager participates with interdisciplinary, inpatient-hospital rounds and collaborates to potentially impact length of stay. This role is eligible for TN sponsorship. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification.
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Number of Employees
5,001-10,000 employees