RN-Acute Care Case Manager

Baptist Memorial Health Care; Memphis (TN); On-site; USD 65,000 - 80,000; Full time

Job summary

Baptist Memorial Health Care in Memphis, TN, seeks an RN Case Manager to coordinate care across the hospital continuum and ensure compliant, efficient transitions for patients. The role requires clinical judgment, collaboration with physicians and payors, and a commitment to high-quality patient outcomes.

The ideal candidate holds an RN license, at least 1 year of clinical experience, and a Certified Case Manager designation; BSN/MSN preferred.

Qualifications

• RN with at least 1 year of clinical experience.
• Certified Case Manager (CCM) certification required.
• 3 years of clinical experience with Case Management in hospital or payer setting preferred.

Responsibilities

• Utilization Review
• Discharge planning
• Readmission Reduction Participation
• Payer Communication and denial reduction
• Completes assigned goals.

Skills

Critical thinking

Communication

Organization

Interpersonal skills

Computer skills

Problem solving

Regulations

Education

Diploma/Associate Nursing

BSN or MSN (preferred)

Job description

Job Summary

Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.

Overview

Job Summary: Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.

Responsibilities

• Utilization Review


• Discharge planning


• Readmission Reduction Participation


• Payer Communication and denial reduction


• Completes assigned goals.

Specifications

Experience

• Minimum Required: RN with at least one (1) year of clinical experience

• Preferred/Desired: RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting

Education

• Minimum Required: Diploma or Associate Degree in Nursing

• Preferred/Desired: BSN or MSN

Training

• Minimum Required: Certified Case Manager

Special Skills

• Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.

• Preferred/Desired: Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.

Licensure

• RN

• RN

• RN;CCM;ACM