RN-Acute Care Case Manager

Baptist Memorial Health Care; Memphis (TN); On-site; USD 70,000 - 90,000; Full time

Job summary

Baptist Memorial Health Care is seeking a Registered Nurse Case Manager to manage care for a defined patient population, coordinating transition across the continuum of care and ensuring appropriate utilization of resources. The role includes early assessment of transitional needs identified during hospitalization and collaboration with care teams.

Minimum requirements include an RN with at least 1 year of clinical experience and a nursing Diploma or Associate Degree; a CCM is preferred.

Qualifications

• RN with at least 1 year of clinical experience.
• Associate degree or diploma in nursing (RN licensure required).
• Certified Case Manager (CCM) preferred.
• Knowledge of payer requirements and governmental regulations.

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

Government regulations

Education

Diploma/Associate Nursing

BSN/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

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.

Experience - Minimum Required

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

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

Education - Preferred/Desired

• BSN or MSN

Training - Minimum Required

• Certified Case Manager

Special Skills

• .

Special Skills - Minimum Required

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

Special Skills - Preferred/Desired

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

Licensure

• RN

Licensure - Minimum Required

• RN

Licensure - Preferred/Desired

• RN;CCM;ACM