is seeking an experienced Registered Nurse Case Manager to join our team! This position is full time.
The RN Case Manager responsibilities include:
Working independently while handling multiple priorities simultaneously.
Utilizes the nursing process of assessment, planning, implementation and evaluation to direct or provide nursing care.
Manages patients across the healthcare continuum to achieve optimal clinical, financial, operational and satisfaction outcomes.
Assess the patients' plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care.
Active participant in the interdisciplinary healthcare team to promote/facilitate discharge planning, facilitating options and services to meet patients' health care needs.
Identifies and intervenes when necessary to ensure efficient and cost-effective delivery of patient care services.
Coordinates the necessity of case management and utilization review for any patient at AZSH.
Provides requested documentation to payors in a timely manner.
Establishes and promotes collaborative relationships with physicians, patients, families and additional members of the healthcare team.
Educates members of the healthcare team on case management and managed care concepts.
Review medical necessity and coordinate with the interdisciplinary team to assure correct status for payment.
Assist with clinical interpretation for denial and appeals management.
Knowledgeable about Medicare, Medicaid, and commercial insurance plans.
Strong analytical, organizational, and time management skills.
Experience with InterQual and or MCG
EMR Experience
Required Skills:
Benefits:
Medical, Dental, Vision
PTO and Sick time Plans
401k after 30 days
Employer Paid Life Insurance
Employee Paid Life Insurance
and more!
Current unencumbered RN license
Recent Case Management experience in a hospital setting
Utilization review experience
Discharge planning in a hospital setting
* Ability to be part of the RN Case Management On Call rotation, with 1-2 on call weekends a month, depending on case load.
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