Case Management RN - Care Coordination & Transitions

UVALDE COUNTY HOSPITAL AUTHORITY UVALDE MEMORIAL HOSPITAL; Uvalde (TX); Sur place; USD 70 000 - 100 000; Plein temps

Résumé du poste

Uvalde Memorial Hospital is seeking a compassionate Case Management Registered Nurse to support appropriate utilization of services and safe transitions after hospitalization.

Responsibilities include utilization reviews, care coordination with physicians, nurses, social workers, and payers, and developing individualized discharge plans. A Texas RN license, BLS, and CCM/ACM within 24 months are required, with 2–5 years of acute care nursing experience preferred.

Qualifications

• Active Texas RN license required.
• BSN strongly preferred.
• Current BLS certification required.
• CCM or ACM certification within 24 months of hire.
• 2–5 years of acute care nursing experience, preferably in case management.
• Strong communication and interpersonal skills.
• Solid organizational skills with caseload management.
• Understanding of Medicare/Medicaid and payer requirements.

Responsabilités

• Perform utilization reviews for admissions, continued stays, and services to evaluate medical necessity.
• Review care against clinical guidelines, payer requirements, and hospital protocols.
• Maintain documentation of utilization findings, decisions, authorizations, and denials.
• Identify opportunities to reduce unnecessary interventions and lengths of stay while maintaining quality care.
• Complete comprehensive patient assessments considering medical, psychosocial, and functional needs.
• Develop individualized care and discharge plans with the interdisciplinary team.
• Begin discharge planning early and coordinate post-discharge resources.
• Educate patients and families about care plans, medications, and follow-up.

Connaissances

RN license

BSN preferred

BLS

CCM/ACM within 24 months

acute care nursing

care coordination

communication skills

organization skills

Formation

Bachelor of Science in Nursing

BSN preferred

Outils

EMR systems

Description du poste

Uvalde Memorial Hospital is seeking a compassionate Case Management Registered Nurse to support appropriate utilization of services and safe transitions after hospitalization.

Responsibilities include utilization reviews, care coordination with physicians, nurses, social workers, and payers, and developing individualized discharge plans. A Texas RN license, BLS, and CCM/ACM within 24 months are required, with 2–5 years of acute care nursing experience preferred.