RN-Case Manager

Baptist Memorial Health Care; Memphis (TN); On-site; USD 62,000 - 86,000; Full time

Job summary

Baptist Memorial Health Care is seeking a Registered Nurse for Case Management in Memphis to oversee care coordination for a specific patient population and ensure safe transitions across the care continuum. You will assess transitional needs during hospitalization and support appropriate resource use and compliance with payer requirements.

The role emphasizes utilization review, discharge planning, and active participation in readmission reduction, with strong emphasis on communication with

Qualifications

• RN with at least one year of clinical experience.
• 3 years of clinical experience with Case Management in hospital or payer setting (preferred).
• Diploma or Associate Degree in Nursing (minimum).
• BSN or MSN (preferred).
• Certified Case Manager (CM) training/credential (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

Education

Diploma or Associate Degree in Nursing

BSN or MSN

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.

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