RN Case Manager Contingent Days Harper University Hospital
Company: Tenet Healthcare Corporation
Posted on: June 12, 2021
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 patients 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 individuals
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. #LI-LB2
Graduate from an accredited school of nursing. Bachelors degree
in Nursing or other health-related field, or equivalent combination
of education and/or related experience.
Two years of acute hospital patient care experience. Acute
hospital case management experience preferred.
License to practice as a Registered Nurse in the State of
Accredited Case Manager (ACM) preferred.
- Must complete Tenets InterQual education course within 30 days
of hire (and at least annually thereafter) and pass with a score of
85 or better. Must complete and demonstrate competency in using the
Tenet Case Management documentation system within 30 days of hire.
Attendance at hospital and department orientation is required.
Department orientation includes review and instruction regarding
Tenet Case Management and Compliance policies, InterQual,
Transition Management, Utilization Management, and other topics
specific to case management.
Keywords: Tenet Healthcare Corporation, Detroit , RN Case Manager Contingent Days Harper University Hospital, Other , Detroit, Michigan
Didn't find what you're looking for? Search again!