for ensuring that care is provided at the appropriate level of care based on medical necessity and to backss 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 individual’s responsibilities include the following activities: Accurate medical necessity screening and submission for Physician Advisor review, Care coordination, Transition planning backssment 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 Education Preferred: Bachelor of Science in Nursing (BSN) Experience Required: Two (2) years acute hospital patient care experience Preferred: Acute hospital case management experience Certifications Required: Active Registered Nurse license Preferred: Accredited Case Manager (ACM) #LI-TM1 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.
If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 210500xyz X Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, interaction (including pregnancy), national origin, age, disability, genetic information, interactionual 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. For more details: jobs-search. org/insurance_el-paso-c424857/rn-case-manager-prn-days-el-paso_i1942932850
