RN Case Manager FT Days

Saint Francis Hospital • Memphis, TN

83d

About The Position

St. Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women's Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/ Surge and Telemetry. The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination. The individual in this position 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 promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case 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 throughput efficiency while assuring care is the right sequence 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.

Requirements

• Graduate of an accredited School of Nursing.
• Two (2) years acute hospital patient care experience.
• BLS certification required.
• ACLS required within 3 months of hire for specific departments.
• PALS or ENPC required within 3 months of hire for specific departments.
• CPI required for specific departments.
• NRP required within 3 months of hire for specific departments.

Nice To Haves

• Bachelor of Science in Nursing (BSN) preferred.
• Acute hospital case management experience preferred.
• Three (3) years acute care experience relevant to the area of specialty occurring within the last five (5) years preferred.
• Two (2) years of case management experience preferred.
• Ability to prepare reports and formal presentations preferred.
• Utilization management experience preferred.
• Accredited Case Manager (ACM) preferred.

Responsibilities

• Facilitate care along a continuum through effective resource coordination.
• Ensure care is provided at the appropriate level based on medical necessity.
• Assess patient transition needs to promote timely throughput and safe discharge.
• Integrate national standards for case management scope of services.
• Conduct accurate medical necessity screening and submission for Physician Advisor review.
• Coordinate care and transition planning assessment and reassessment.
• Implement or oversee the implementation of the transition plan.
• Lead and facilitate multi-disciplinary patient care conferences.
• Manage concurrent disputes and make appropriate referrals to other departments.
• Identify and refer complex patients to Social Work Services.
• Communicate with patients and families about the plan of care.
• Collaborate with physicians, office staff, and ancillary departments.
• Lead and facilitate Complex Case Review.
• Ensure patient education is completed to support post-acute needs.
• Maintain accurate patient demographic and insurance information.
• Identify and document potentially avoidable days and report over and underutilization.
• Complete timely and concise documentation in Case Management system.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree