RN Case ManagerThe RN Case Manager in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning. RN Case Manager Responsibilities: Medical necessity screening Care coordination Discharge planning Facilitating multi-disciplinary patient care conferences Managing concurrent disputes Making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) Referring complex social issues to Social Service Communicating with patients and their families about the plan of care Collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) Participating in weekly Complex Case Review Arranging for post –discharge patient education Clear, complete and concise documentation in eCCM Maintaining accuracy of patient demographic and insurance information Identifying and documenting potentially avoidable days Identifying and reporting over and underutilizationQualifications: Education: B.S.N.
preferred, at least 5 year's bedside nursing experience required Certification/License: Current Professional Nurse License issued and/or recognized by Board of Nurse Examiners for the State of Texas CCM or ACMA preferred Experience: Acute care Hospital Case Management Experience required; Must have experience with InterQual criteria application 5+ to 7 years experience Minimum Education - Bachelor's DegreeAll your information will be kept confidential according to EEO guidelines.