Registered Nurse Case Manager Per Diem Days BMC

Summary

Registered Nurse / RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination. Registered Nurse / RN Case Manager has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to provide timely throughput, safe discharge and prevent avoidable readmissions. Integrates the national standards for care management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating efficient throughput while assuring care is sequenced and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patients, families and caregivers. Registered Nurse / RN Case Manager completes established competencies for the position within designated introductory period.  Other related duties as assigned to Registered Nurse / RN Case Manager

 

Qualifications

Education

Required: Graduate of an accredited School of Nursing
Preferred: Bachelors or Masters Degree in Nursing 

Experience

Required: Two (2) years acute hospital patient care experience. Utilization/case management experience.  

Certifications

Required: Possession of current Texas State license for Registered Nurse
Preferred: AccreditedCase Management (ACM)

Required Courses/Licensure

BLS-Obtained through approved American heart Association Training Center or the Military Training Network

#LI-NS1

Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

The individual’s responsibilities include the following activities:
a) accurate medical necessity screening and submission for Physician Advisor review,
b) care coordination,
c) transition planning assessment and reassessment,
d) implementation or oversight of implementation of the transition plan,
e) leading and facilitating multi-disciplinary patient care conferences,
f) managing concurrent disputes,
g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services,
I) communicating with patients and families about the plan of care,
j) collaborating with physicians, office staff and ancillary departments,
k) leading and facilitating Complex Case Review,
l) assuring patient education is completed to support post-acute needs ,
m) timely complete and concise documentation in Case Management system,
n) maintenance of accurate patient demographic and insurance information,
o) identification and documentation of potentially avoidable days,
p) identification and reporting over and underutilization,
q) and other duties as assigned.

Education:

Required: Graduate of an accredited school of nursing
Preferred: Academic degree in nursing (bachelor's or master's)

Experience:

Required: 2 years of acute hospital patient care experience
Preferred: Acute hospital case management experience

Certifications:

Required: RN. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.
Preferred: Accredited Case Manager (ACM)

Physical Demands:

Lift/position up to 25 lbs. Push/pull up to 25 lbs. of force. Frequent sitting. Moderate standing, walking, reaching, stooping, and bending. Manual dexterity, mobility, touch, auditory to perform all the related duties of the position.

Who We Are
We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community.
Our Story
We started out as a small operation in California. In May 1969, we acquired four ho