Description

This position may qualify for a sign-on bonus.

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.

2503027076

Qualifications

Minimum Education

Required qualifications should include

a) RN (minimum of B.S.N. preferred) with at least 3 year’s beside experience. (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.