C

Registered Nurse (RN) - Case Manager

Children's Hospital of Michigan
Full-time
On-site
Detroit, Michigan, United States
Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work‑life balance.

Benefit Statement

Medical, dental, vision, and life insurance

401(k) retirement savings plan with employer match

Generous paid time off (PTO)

Career development and continuing education opportunities

Health savings accounts, healthcare dependent flexible spending accounts

Employee Assistance program, Employee discount program

Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder childcare, auto and home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status.

Job Description
As the RN Case Manager, you will facilitate care across a continuum through effective resource coordination, ensuring patients achieve optimal health and appropriate utilization of resources. You will be responsible for medical necessity assessment, care coordination, transition planning, and compliance with regulatory requirements.

Responsibilities

Accurate medical necessity screening and submission for Physician Advisor review

Care coordination across interdisciplinary teams

Transition planning assessment and reassessment

Implementation or oversight of the transition plan

Leading and facilitating multi‑disciplinary patient care conferences

Managing concurrent disputes

Making appropriate referrals to other departments

Identifying and referring complex patients to Social Work Services

Communicating with patients and families about the plan of care

Collaborating with physicians, office staff, and ancillary departments

Leading and facilitating Complex Case Review

Assuring patient education is completed to support post‑acute needs

Timely completion and concise documentation in the Case Management system

Maintaining accurate patient demographic and insurance information

Identification and documentation of potentially avoidable days

Identification and reporting of over‑and under‑utilization

Other duties as assigned

Utilization Management
Balance clinical and financial resources, advocate for patient needs, and manage utilization using evidence‑based practice. Advocate for appropriate payment and reduce denials through effective communication.

Transition Management
Identify patients at risk for readmission, develop and implement transition plans, and ensure completion and communication to the healthcare team and patients.

Care Coordination
Screen patients for factors affecting care progression, collaborate with the healthcare team, and ensure care sequencing aligns with patient needs.

Education
Provide education to patients, families, and the healthcare team regarding resources, benefits, and economic impact of care options.

Compliance
Ensure compliance with federal, state, and local regulations, accreditation requirements, and Tenet policies.

Qualifications

Graduate from an accredited school of nursing; Bachelor's degree in Nursing or related field, or equivalent experience.

Two years of acute hospital patient care experience; acute hospital case management experience preferred.

License to practice as a Registered Nurse in the State of Michigan.

Accredited Case Manager (ACM) preferred.

Must complete Tenet InterQual education course within 30 days of hire and demonstrate competency in the Tenet Case Management documentation system within 30 days.

Attendance at hospital and department orientation is required.

Vaccination Statement
Tenet Healthcare complies with federal, state, and local laws regarding mandatory vaccination of its workforce. If required, proof of full vaccination or an approved exemption must be provided before start date. If an exemption is granted, regular testing will be required in accordance with the law.

Facility Description
Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. It offers surgical services, imaging technology, a Level 1 Pediatric Trauma Center, and specialized care across multiple sites.

EEO Statement
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program.

#J-18808-Ljbffr
Apply now
Share this job