Overview RN-Case Manager at Baptist Memorial Health Care. Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities Utilization Review
Discharge planning
Readmission Reduction Participation
Payer Communication and denial reduction
Completes assigned goals
Qualifications Minimum Required
RN with at least one (1) year of clinical experience
Preferred/Desired
RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Education Minimum Required
Diploma or Associate Degree in Nursing
Preferred/Desired
BSN or MSN
Training Preferred/Desired
Certified Case Manager
Special Skills Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Preferred/Desired
Knowledge of payer requirements; problem solving; and governmental regulations.
Licensure RN
Minimum Required
RN
Preferred/Desired
RN;CCM;ACM
Seniority level Entry level
Employment type Other
Job function Health Care Provider
Industries: Hospitals and Health Care
Memphis, TN