Registered Nurse Case Manager (RN)

Tenet Healthcare Corporation • Tucson, AZ

3d • Onsite

About The Position

The Registered Nurse Case Manager is a professional nurse with advanced clinical knowledge and skills gained through education and in-depth clinical experience. The role coordinates and facilitates patient hospitalization from pre-admission through post-discharge, collaborating with physicians, nurses, social workers, and other health team members to support medically appropriate, cost-effective care. The nurse applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning, with the goal of achieving health maintenance and disease prevention outcomes. The position advises and provides leadership to the health care team, communicates across departments and care settings, and supports improved clinical management and medical and psychosocial care across the health care continuum. Core processes include risk assessment and management of clinical populations, discharge planning, and utilization management.

Requirements

• Associate degree in nursing or a related field, or an equivalent combination of work experience and education.
• Recent acute care experience.
• Valid current Arizona nursing license or compact-state license, with ability to become Arizona licensed within 30 days.
• Basic Life Support (BLS) certification.
• American Heart Association Advanced Cardiac Life Support (ACLS) certification.
• Pediatric Advanced Life Support (PALS) certification.
• Crisis Prevention Institute (CPI) certification.
• NIH Stroke Scale (NIHSS) certification and other requirements as specified by the individual department.

Nice To Haves

• Bachelor’s degree in nursing.
• Combined bedside and care management experience.
• Certification in a specialty area and/or case management.

Responsibilities

• Review, using established criteria, the appropriateness of patient admission, need for continued stay, and information needed for discharge.
• Discuss estimated length of stay, treatment, and discharge plans with the attending physician, as indicated.
• Initiate discharge planning by assessing patient needs and documenting the assessment on the interdisciplinary plan of care.
• Interview patients, families, and appropriate health team members to develop a discharge plan that incorporates patient choice and is clinically appropriate, cost-effective, and safe.
• Ensure the interdisciplinary care plan and discharge plan are consistent with the patient’s clinical course, continuing care needs, and covered services.
• Refer complex discharge planning issues to other case management team members according to referral criteria.
• Provide leadership to the health care team to implement discharge plans and facilitate transfer to the next level of care when the patient is medically able.
• Obtain third-party payer certification following patient status changes and obtain information needed for discharge.
• Conduct interdisciplinary rounds.
• Discuss the appropriateness of resource utilization, consultation, and treatment plans with the attending physician and/or physician advisor.
• Collect data on variances from quality screening criteria established by the Clinical Excellence Council and report quality concerns to Quality Assurance; continually support and enhance quality outcomes.
• Respond to third-party requests for concurrent clinical information.
• Complete necessary forms in a timely manner.
• Act as a liaison and patient advocate, influencing interactions to ensure high-quality patient care.
• Coordinate appropriate educational materials and instruction for patients, families, medical staff, and multidisciplinary personnel to accomplish patient care outcomes.
• Maintain cost-effective utilization of care continuum resources.
• Coordinate with staff to develop a mechanism for monitoring patient progress against guidelines and evaluating variances for individual patients and targeted populations.
• Identify possible delays and avoidable days; work with providers to prevent delays and identify system or provider opportunities for improvement.
• Perform other duties as assigned.

Benefits

• Medical, dental, vision, and life insurance.
• 401(k) retirement savings plan with employer match.
• Paid time off.
• Career development and continuing education opportunities.
• Health savings accounts and healthcare and dependent flexible spending accounts.
• Employee Assistance Program.
• Employee discount program.
• Voluntary pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder and childcare, and auto and home insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree