Texas Licensed Case Manager RN

Supporting denials, appeals, and compliance activities, the part-time Per Diem Texas Licensed Case Manager RN will conduct patient chart reviews, write appeal letters, and perform audits to ensure regulatory compliance within the Care Management Department. Key responsibilities Conduct patient chart reviews and write appeal letters to address denials and compliance issues Perform various audits to support departmental and hospital regulatory requirements Utilize sound decision-making and prioritization skills to address patient needs effectively Required qualifications Active LVN CA and TX licenses; RN CA and TX licenses preferred Minimum of 2 years acute hospital experience Proficiency with main-frame and personal computers Knowledge of medical terminology and third-party payor reimbursement methodologies Experience in managed care and case management is a plus