Job Description

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Overview

Join our team as a day shift, full-time, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas.

Fulfilling your purpose begins here:

People First, Always. Here\xe2\x80\x99s how we take care of our people:

• Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more.

Your team is bigger than your department:

• The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support.
• We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.

Responsibilities

• The Case Manager coordinates care for high risk/complex patients and families by collaborating with the patient, family, physician, nurses, and other members of the healthcare team to identify needs and expedite appropriate, cost effective care.
• Advises the healthcare team and provides leadership in issues of outcomes management and development of improved strategies to benefit high risk patients.
• Provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type.
• Provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent and retrospective reviews.
• Intervenes when potential denials are determined and files appeals when denials are received.
• Partners with physician related to resource utilization including LOS and cost per case.
• Reports to the Clinical Resource Management Director.

Qualifications

Job Requirements:

• Current licensure by Kansas State Board of Nursing.
• Minimum of 3 years as a professional nurse in direct patient care with demonstrated clinical expertise.

Preferred Job Requirements:

• Current certification as a Care Assessor for the State of Kansas or obtain within 6 month of hire.
• Previous experience as a case manager or utilization review nurse.

Seton Medical Center Harker Heights