Registered Nurse Case Manager (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; 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. Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Saint Luke's Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.
Requirements
- Registered Nurse (RN) license
- Experience in case management
- Knowledge of medical necessity and denial prevention
- Understanding of appropriate length of stay and readmission prevention
- Ability to demonstrate efficient throughput and appropriate care sequencing
- Knowledge of state and federal regulatory requirements, TJC accreditation standards, and Tenet policy
- Ability to educate physicians, patients, families, and caregivers
- Completion of established competencies within the designated introductory period
Nice To Haves
- Results-driven leader
- Innovative and experienced healthcare leader
- Ability to inspire a team towards exceptional patient outcomes and operational success
Responsibilities
- Facilitate care along a continuum through effective resource coordination.
- Ensure patients achieve optimal health, access to care, and appropriate utilization of resources.
- 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 including Utilization Management, Transition Management, and Care Coordination.
- Ensure compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy.
- Provide education to physicians, patients, families, and caregivers.
- Complete established competencies for the position within the designated introductory period.
- Perform other related duties as assigned.
Benefits
- Medical, dental, vision, and life insurance
- 401(k) retirement savings plan with employer match
- Generous paid time off
- Career development and continuing education opportunities
- Health savings accounts
- Healthcare & dependent flexible spending accounts
- Employee Assistance program
- Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
