Registered Nurse (RN) - Case Manager

Tenet Healthcare Corporation • El Paso, TX

2d

About The Position

The RN Case Manager facilitates care across the continuum through effective resource coordination, helping patients achieve optimal health, access care, and use resources appropriately while respecting their resources and right to self-determination. The role ensures that care is delivered at the appropriate level based on medical necessity and assesses transition needs to support timely throughput, safe discharge, and prevention of avoidable readmissions.

The position integrates national case management standards, including utilization management to support medical necessity and prevent denials; transition management to promote appropriate length of stay, prevent readmissions, and support patient satisfaction; care coordination to ensure efficient throughput and care in the appropriate sequence and setting; compliance with state and federal requirements, TJC accreditation standards, and Tenet policy; and education for physicians, patients, families, and caregivers.

Requirements

• Graduate of an accredited school of nursing.
• Two years of acute hospital patient care experience.
• Currently licensed, certified, or registered to practice as required by law or regulation in the state of practice or policy.
• Active RN license for the state(s) covered.

Nice To Haves

• Academic degree in nursing (bachelor's or master's).
• Acute hospital case management experience.
• Accredited Case Manager (ACM) certification.

Responsibilities

• Accurately screen for medical necessity and submit cases for Physician Advisor review.
• Coordinate care.
• Assess and reassess transition-planning needs.
• Implement or oversee implementation of the transition plan.
• Lead and facilitate multidisciplinary patient care conferences.
• Manage concurrent disputes.
• Make appropriate referrals to other departments.
• Identify complex patients and refer them to Social Work Services.
• Communicate the plan of care to patients and families.
• Collaborate with physicians, office staff, and ancillary departments.
• Lead and facilitate Complex Case Review.
• Ensure patient education is completed to support post-acute needs.
• Complete timely, accurate, and concise documentation in the Case Management system.
• Maintain accurate patient demographic and insurance information.
• Identify and document potentially avoidable days.
• Identify and report overutilization and underutilization.
• Perform other 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 and healthcare and dependent flexible spending accounts.
• Employee Assistance program.
• Employee discount program.
• Voluntary benefits including 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
• Education Level: Associate degree