Tenet Healthcare
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RN Case Manager I FT Days
role at
Tenet Healthcare .
St. Francis Hospital Memphis Saint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women’s Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/Surg and Telemetry.
RN Case Manager I Full Time Days Position Summary
The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
Education provided to physicians, patients, families and caregivers
The individual’s responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs, m) timely complete and concise documentation in Case Management system, n) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned.
Education
REQUIRED: Graduate of an accredited School of Nursing. Preferred: Bachelor of Science in Nursing (BSN).
Experience
REQUIRED: Two (2) years acute hospital patient care experience. Preferred: Acute hospital case management experience. EXPERIENCE PREFERRED: Three (3) years acute care experience relevant to the area of specialty occurring within the last five (5) years. Two (2) years of case management experience. Ability to prepare reports and formal presentations preferred. Utilization management experience.
Certifications
Required: BLS certification. ACLS required within 3 months of hire for ED, ICU, SDU, HS, FLOAT, TELE, MS, GIL, IR, L&D, PACU, and SDS. PALS or ENPC required within 3 months of hire for ECC, PACU, HS, SDS and Float. CPI required for ED, Float, NA and HS. NRP required within 3 months of hire for LD and NICU. Preferred: Accredited Case Manager (ACM).
Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Seniority level
Executive
Employment type
Full-time
Job function
Health Care Provider
Industries: Hospitals and Health Care and Medical Practices
Memphis, TN
Location details and compensation vary by posting. This description reflects the role as advertised and may be subject to change.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
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RN Case Manager I FT Days
role at
Tenet Healthcare .
St. Francis Hospital Memphis Saint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women’s Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/Surg and Telemetry.
RN Case Manager I Full Time Days Position Summary
The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
Education provided to physicians, patients, families and caregivers
The individual’s responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs, m) timely complete and concise documentation in Case Management system, n) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned.
Education
REQUIRED: Graduate of an accredited School of Nursing. Preferred: Bachelor of Science in Nursing (BSN).
Experience
REQUIRED: Two (2) years acute hospital patient care experience. Preferred: Acute hospital case management experience. EXPERIENCE PREFERRED: Three (3) years acute care experience relevant to the area of specialty occurring within the last five (5) years. Two (2) years of case management experience. Ability to prepare reports and formal presentations preferred. Utilization management experience.
Certifications
Required: BLS certification. ACLS required within 3 months of hire for ED, ICU, SDU, HS, FLOAT, TELE, MS, GIL, IR, L&D, PACU, and SDS. PALS or ENPC required within 3 months of hire for ECC, PACU, HS, SDS and Float. CPI required for ED, Float, NA and HS. NRP required within 3 months of hire for LD and NICU. Preferred: Accredited Case Manager (ACM).
Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Seniority level
Executive
Employment type
Full-time
Job function
Health Care Provider
Industries: Hospitals and Health Care and Medical Practices
Memphis, TN
Location details and compensation vary by posting. This description reflects the role as advertised and may be subject to change.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr