RN-Case Manager

Baptist; Memphis (TN); On-site; USD 60,000 - 80,000; Full time

Job summary

Baptist is seeking an RN Case Manager to oversee patient care coordination, discharge planning, and utilization review, ensuring safe transitions and compliance with payer requirements.

The role emphasizes clinical practice, collaboration with multidisciplinary teams, and adherence to regulatory standards. A Diploma/ASN is required, with BSN/MSN preferred and CCM training advantageous.

Qualifications

• RN with at least one year of clinical experience.
• Preference for 3 years of clinical experience with Case Management in hospital or payer setting.
• Diploma or Associate Degree in Nursing required.
• BSN or MSN preferred.
• Certified Case Manager training 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

Payer knowledge

Regulatory knowledge

Education

Diploma/Associate Degree in Nursing

BSN/MSN preferred

Job description

• Department Case Management Administration

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.

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