Summary 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.
Requirements, Preferences and Experience Education Preferred: BSN or MSN Minimum: Diploma or Associate Degree in Nursing
Experience Preferred: RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting Minimum: RN with at least one (1) year of clinical experience
Licensure, Registration, Certification Preferred: RN;CCM;ACM Minimum: RN
Special Skills Preferred: Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations. Minimum: Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Training Preferred: Certified Case Manager
About Baptist Memorial Health Care At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer: - Competitive salaries
- Paid vacation/time off
- Continuing education opportunities
- Generous retirement plan
- Health insurance, including dental and vision
- Sick leave
- Service awards
- Free parking
- Short-term disability
- Life insurance
- Health care and dependent care spending accounts
- Education assistance/continuing education
- Employee referral program
Job Summary: Position: 1913 - RN-Case Manager Facility: BMH - Memphis Hospital Department: ME Case Management Admin Baptist Memphis Category: Nurse RN Type: Non Clinical Work Type: Full Time Work Schedule: Rotating Location: US:TN:Memphis Located in the Memphis metro area