RN Psych Case Manager 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 patientâ��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
Responsibilities The individualâ��s responsibilities include the following activities:
Accurate medical necessity screening and submission for Physician Advisor review, Care coordination, Transition planning assessment and reassessment, Implementation or oversight of implementation of the transition plan, Leading and facilitating multi-disciplinary patient care conferences, Managing concurrent disputes, Making appropriate referrals to other departments, h ) 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 complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, Identification and documentation of potentially avoidable days, Identification and reporting over and underutilization, And other duties as assigned
THE RN PSYCH CASE MANAGER FULL TIME DAYS CANDIDATE WILL POSSESS THE FOLLOWING EDUCATION, LICENSE/CERTIFICATIONS, AND EXPERIENCE. Required qualifications should include a) R.N. (minimum of B.S.N. preferred) with at least 3 to 5 yearâ��s experience in the relevant clinical specialty (e.g., case manager for pediatrics patients should have pediatric nursing experience) b) excellent organizational skills c) excellent verbal and written communication skills; d) ability to lead and coordinate activities of a diverse group of people; e) demonstrated critical thinking and problem solving skills; and g) computer literate
Case Managers hired prior to August 2009 are grandfathered in with the same performance expectations.
Minimum Licensure and Certification: A valid Permanent Multi-State RN License from the state in which you reside is required. Should you hold a RN license from another Compact state, you are required to apply for and obtain a Multi-State RN License from the state in which you reside within 30 days. BSN preferred. BLS Required.
Minimum Experience/Additional Certification: 3 â�� 5 years RN clinical experience. Case Management experience preferred.
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��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 Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.