Registered Nurse (RN) Case Manager
• Performs continuous assessments and evaluations to ensure the patient is progressing towards desired outcomes.
• Assesses and responds to patient/family needs by coordinating efforts of other team members.
• Identifies and resolves barriers that hinder effective patient care.
• Collaborates and consults with physicians on patient's progress and discharge planning needs.
• Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity.
• Manages the process to review and, as appropriate, appeal denials received from payors.
• Coordinates the discharge planning process ensuring the involvement of all members of the healthcare team. Counsels with patients and family members in decision making and in meeting psychosocial needs of the patient.
• Maintains knowledge of resources and facilities available to patients and family members.
• Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions.
Qualification you will need:
• Current RN License
• Graduate of an accredited school of professional nursing. Bachelor's of Science in Nursing preferred
• CCM preferred
• Minimum 2 years of clinical nursing experience
• Knowledge of CMS guidelines and experience working with payor specific guidelines and contractual rules preferred
Salary: $75, 000/ yearly This position is a full-time, fully benefited work opportunity!
Excellent benefits package and growth opportunities. Benefits include 401k, PTO medical, dental, flex spending, life, disability, and tuition reimbursement.