RN-Acute Care Case Manager

Baptist Memorial Health Care Corporation; Memphis (TN); On-site; USD 65,000 - 85,000; Full time

Job summary

Baptist Memorial Health Care Corporation is seeking an RN Case Manager to oversee care coordination for a defined patient population within a hospital setting. Responsibilities include utilization review, discharge planning, and active participation in reducing readmissions and payer denials.

The role emphasizes critical thinking, strong communication, and adherence to regulatory requirements, with preferred experience in case management in hospital or payer environments.

Qualifications

• RN with at least one year of clinical experience.
• Certification in case management is preferred.
• Familiarity with payer requirements and 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

Regulatory knowledge

Education

Diploma or Associate Degree in Nursing

BSN or MSN

Job description

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

Preferred/Desired

• Certified Case Manager

Special Skills

• .

Minimum Required

• 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

Minimum Required

• RN

Preferred/Desired

• RN;CCM;ACM