Registered Nurse Case Manager Full Time Days

Positon Summary

The RN Case Manager is responsible for a)  Follow up on patient accounts when authorization for stay is required , Fax numbers to Send clinical reviews  b) Follow up on each account during the stay and on discharge for authorization - document in the electronic system, c) Escalate any potential disputes or denial of accounts to Director of Case Management or designee  d) Trends disputed claims by at least payor and physician e) assist in obtaining authorization for patient discharged to Skilled Facilities or other post-acute care that require authorization f)  other duties as assigned. Assisting with coordinating clinically complex patients care across a continuum; ensuring and facilitating the achievement of quality clinical and cost outcomes; negotiating, procuring and coordinating appropriate services and resources needed by the patient; and at key points, intervening to address and resolve issues/concerns. This individual is responsible for coordinating the clinical plan of care to conform to the evidence-based practice and regulatory requirements.  This position integrates care coordination unitization management, and discharge planning. 

Minimum Education

Required qualifications should include

a) RN (minimum of B.S.N. preferred) with at least 3 year’s beside experience or a LPN/LVN with 10 years in the relevant clinical specialty (e.g. , case manager for pediatrics patients should have pediatric nursing experience,

b) excellent organizational skills,

c) excellent verbal and written communication skills;

d) ability to lead and coordinate activities of a diverse group of people;

e) demonstrated critical thinking and problem solving skills; and g) computer literate

 

#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. 

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 hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care.
We have a rich history at Tenet. There are so many stories of compassionate care; so many "firsts" in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others.
Our Impact Today
Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions.
Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions.
Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day.