RN Case Manager: Care Coordination & Utilization

Tenet Healthcare; San Antonio (TX); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical, dental, vision, and life保险

401(k) employer match

Generous paid time off

Career development opportunities

Health savings accounts

Employee Assistance program

Voluntary benefits

Job summary

Baptist Health System is seeking a Registered Nurse Case Manager to coordinate utilization management and authorize appropriate levels of care for patients. The role emphasizes collaboration with payers, physicians, and hospital staff to ensure medical necessity and optimal resource use.

The position requires an active RN license and nursing education, with a focus on case management. Tenet Case Management systems and InterQual training are part of the onboarding process, supporting quality care

Qualifications

• MINIMUM EDUCATION: Graduate of an accredited School of Nursing.
• PREFERRED EDUCATION: Bachelors or Masters Degree in Nursing.
• MINIMUM EXPERIENCE: 2 years acute hospital or behavioral health patient care experience; 1 year utilization review.
• PREFERRED EXPERIENCE: Previous Case Management Supervisory experience.

Responsibilities

• Coordinate utilization management to authorize appropriate care and length of stay.
• Collaborate with payers to ensure medical necessity and coverage.
• Educate staff and payers on covered services and Tenet policies.
• Perform other related duties as assigned.

Skills

Utilization Management

Case Management

InterQual knowledge

Payer coordination

Negotiation with payers

Education

RN licensure

Graduate of an accredited School of Nursing

Bachelor or Master in Nursing (preferred)

Tools

Tenet Case Management system

InterQual course completion

Job description

Baptist Health System is seeking a Registered Nurse Case Manager to coordinate utilization management and authorize appropriate levels of care for patients. The role emphasizes collaboration with payers, physicians, and hospital staff to ensure medical necessity and optimal resource use.

The position requires an active RN license and nursing education, with a focus on case management. Tenet Case Management systems and InterQual training are part of the onboarding process, supporting quality care