Summary

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient�s resources and right to self-determination.
The individual in this position 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 promote timely throughput, safe discharge and prevent avoidable readmissions.
This position integrates national standards for case 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 throughput efficiency while assuring care is the right sequence 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
Leads a population of patients by service line.

Responsibilities

• Precepts new staff members and acts as resource to all staff.
• Facilitates TEMPO as needed.
• Participates in department Quality improvement initiatives.
• At least one committee participation or major Projects as assigned

Education

Required: Bachelor of Science in Nursing (BSN) if Magnet hospital.
Preferred: Bachelor of Science in Nursing (BSN).

Experience

Required: Two years department experience.

Certifications

Required: Registered Nurse License.
Preferred: Accredited Case Manager (ACM)