RN-Case Manager PRN

Baptist; Memphis (TN); On-site; USD 60,000 - 75,000; Full time

Job summary

Baptist in Memphis, TN, seeks a dedicated RN for case management to oversee patient transitions throughout care. The role emphasizes utilization review, discharge planning, and communication with payers. Required qualifications include an RN with at least one year of clinical experience, along with preferred credentials such as a BSN or Certified Case Manager. Join a vital team in enhancing patient care and ensuring compliance with regulations.

Qualifications

• RN with at least one (1) year of clinical experience.
• Experience with Case Management in a hospital or payer setting preferred.
• Knowledge of payer requirements and governmental regulations.

Responsibilities

• Manage care for specific patient populations and facilitate transitions.
• Conduct Utilization Review and discharge planning.
• Participate in readmission reduction initiatives.

Skills

Critical thinking skills

Communication

Organization

Interpersonal skills

Computer skills

Education

Diploma or Associate Degree in Nursing

BSN or MSN

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.

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

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