RN CASE MANAGER

Direct Staffing Inc; Dallas (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading staffing agency is seeking an RN Case Manager responsible for overseeing the clinical plan of care. The role integrates care coordination, utilization management, and discharge planning, ensuring patient needs are met in compliance with regulatory requirements. Candidates should possess a Bachelor's degree and extensive nursing experience, particularly in acute care.

Qualifications

• At least 5 years bedside nursing experience required.
• Acute care Hospital Case Management experience required.
• Experience with InterQual criteria application.

Responsibilities

• Overall responsibility for overseeing clinical plan of care.
• Facilitating multi-disciplinary patient care conferences.
• Making appropriate referrals to other departments.

Skills

Care coordination

Discharge planning

Documentation

Education

B.S.N.

Bachelor's Degree

Job description

The RN Case Manager in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.

RN Case Manager Responsibilities:
Medical necessity screening
Care coordination
Discharge planning
Facilitating multi-disciplinary patient care conferences
Managing concurrent disputes
Making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST)
Referring complex social issues to Social Service
Communicating with patients and their families about the plan of care
Collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy)
Participating in weekly Complex Case Review
Arranging for post –discharge patient education
Clear, complete and concise documentation in eCCM
Maintaining accuracy of patient demographic and insurance information
Identifying and documenting potentially avoidable days
Identifying and reporting over and underutilization
Qualifications:
Education: B.S.N. preferred, at least 5 year's bedside nursing experience required

Certification/License: Current Professional Nurse License issued and/or recognized by Board of Nurse Examiners for the State of Texas
CCM or ACMA preferred

Experience: Acute care Hospital Case Management Experience required;
Must have experience with InterQual critieria application

5+ to 7 years experience

Minimum Education - Bachelor's Degree

Additional Information

All your information will be kept confidential according to EEO guidelines.