Registered Nurse Case Manager (RN) - Case Management

Socket.dev; San Antonio (TX); On-site; USD 90,000 - 110,000; Full time

Benefits offered by this job

Medical benefits

401(k) with match

Paid time off

Career development

Job summary

Mission Trail Baptist Hospital is seeking an experienced nursing leader to optimize care coordination across the continuum. You will oversee utilization management, ensure appropriate transitions, and prevent readmissions while aligning with medical necessity and regulatory standards.

The role emphasizes education for clinicians, patients and families, with a focus on safe discharge, throughput, and patient satisfaction.

Qualifications

• Graduate of an accredited School of Nursing.
• Minimum 2 years acute hospital patient care experience.
• Current Texas State license for Registered Nurse (RN).
• ACM certification preferred.

Responsibilities

• Facilitate care coordination along the continuum of care.
• Assess transition needs to ensure timely throughput, safe discharge and prevent readmissions.
• Ensure care is provided at the appropriate level of care based on medical necessity.
• Comply with regulatory standards, TJC and Baptist policy; support utilization management.
• Educate physicians, patients, families and caregivers on care plans and resources.

Skills

Care coordination

Utilization management

Transition management

Education and training

Regulatory compliance

Education

Graduate of an accredited School of Nursing

Bachelor's or Master's Degree in Nursing

Tools

EHR systems

Utilization review software

Job description

Responsible to facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access tocare and appropriate utilization of resources balanced with the patient’s resources and right to self-determination. Has overallresponsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient fortransition needs to provide timely throughput, safe discharge and prevent avoidable readmissions. Integrates the national standards for care management scope of services including: Utilization Management supporting medical necessity and denial prevention; TransitionManagement promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstratingefficient throughput while assuring care is sequenced and at appropriate level of care; Compliance with state and federal regulatoryrequirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patients, families and caregivers. Completes established competencies for the position within designated introductory period. Other related duties as assigned

Qualifications

Education:
MINIMUM EDUCATION: Graduate of an accredited School of Nursing
PREFERRED EDUCATION: Bachelors or Master's Degree in Nursing

Experience:
MINIMUM EXPERIENCE: 2 years acute hospital patient care experience. Utilization/case management experience.

Certifications:
REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State license for Registered Nurse
PREFERRED CERTIFICATIONS/LICENSURE: Accredited Case Management (ACM)

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Mission Trail Baptist Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

At Mission Trail Baptist Hospital, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

• 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, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status

Baptist Health System has more than 120 years history of caring for our community and making a positive difference. Our system of care includes six full-service hospitals, a specialized childrens hospital with a dedicated pediatric emergency unit, a comprehensive cancer care network, fitness and rehabilitation centers, a physician network, imaging centers, ambulatory services and the Baptist School of Health Professions. Wherever you go in the Baptist Health System, youll find that we have the same goal to help people achieve health for life through compassionate service inspired by faith. Join our team!