RN Case Manager FT Days

Carondelet Holy Cross Hospital • Nogales, AZ

121d

About The Position

Welcome to Carondelet Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine connections and heartfelt compassion. It's what sets us apart and makes us truly special. When you join our team, you're not just stepping into a job - you're becoming part of a community that uplifts and supports each other every day. We know that healthcare requires a unique blend of talent and dedication, and we are fully committed to providing an environment that enriches and rewards your journey. Picture yourself among the brightest healthcare professionals, all united by a common purpose: caring for our community with unwavering commitment. At Carondelet, you won't just find colleagues; you'll find awe-inspiring teammates who share your passion for making a meaningful impact. If you're ready to go above and beyond, to embrace the energy and camaraderie that Carondelet Health System offers, then join us on this incredible adventure. Together, we'll create a healthier, happier world - one patient at a time. Let your career find its purpose here at Carondelet.

Requirements

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

Nice To Haves

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

Responsibilities

• Facilitate care along a continuum through effective resource coordination to help patients achieve optimal health.
• Ensure care is provided at the appropriate level based on medical necessity.
• Assess patients for transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions.
• Support Utilization Management for medical necessity and denial prevention.
• Promote appropriate length of stay, readmission prevention, and patient satisfaction.
• Demonstrate throughput efficiency while assuring care is in the right sequence and at the appropriate level.
• Comply with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy.
• Provide education to physicians, patients, families, and caregivers.
• Conduct accurate medical necessity screening and submission for Physician Advisor review.
• Coordinate care and assess transition planning.
• 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 timely, complete, and concise documentation in the Case Management system.
• Maintain accurate patient demographic and insurance information.
• Identify and document potentially avoidable days.
• Identify and report over and underutilization.

Benefits

• Travel stipend of $60 per day for those traveling more than 60 miles one way.

What This Job Offers

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