RN Case Manager/UR Reviewer

3 weeks ago

Lubbock TX, United States Lubbock Heart Hospital Full time
RN Case Manager/UR Reviewer

JOIN OUR TEAM Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees love their work here. Many have been with us from the very beginning. Because we're physician-owned, we understand the value of having a well-trained, well-resourced staff. When it comes to procedural healthcare, experience matters. Lubbock Heart & Surgical Hospital is committed to providing better outcomes for our employees * Great Benefits - Medical, Vision, Dental, PTO & 401K * Individually Tailored 6-12 Week Orientation * Opportunities for Advancement * Career Ladder for RNs, LVNs, & CSTs * Consumer discounts through Perks * Family Atmosphere * Opportunity for Multi-Unit Training * Free CEUs through Cornerstone, our online training system We are looking for a dedicated RN Case Manager/Utilization Review like you to join our Lubbock Heart team. What You Will do in this Role: * Review medical records concurrently for appropriateness of level of care and discharge planning. * Review medical records concurrently for insurance and managed care reviews. * Review all patient admission data on a concurrent basis within the designated time frames to determine the suitability of the level of care in accordance with Texas Medical Foundation and/or other criteria. * Collaborate with the attending physician if the case does not meet admission or continued stay criteria. Refers unresolved issues and questionable reviews to the Director of Case Management/CDI. * Document all utilization review activity on the appropriate forms. * Develop and maintain an effective working relationship with physicians and staff. * Work with patients and families to identify resources and additional avenues for post-hospital care and support. * Coordinate with nursing to help with discharge teaching. * Work with other agencies to identify placement, transportation, funding, medications, and other protocols as needed in a cost effective manner. * Prepare and maintain essential records and reports. * Assure a sage and therapeutic environment for patients and staff. * Identify and implement actions to improve clinical services. * Organize time and sets priorities to accomplish work load. * Deal with conflict and problematic situations in an open, respectful, and tactful manner. * Support, assist, and adhere to implementation of the organization mission and vision. * Organize use of resources to assure efficient operation. What Qualifications You Will Need: * Current Registered Nurse licensure in the State of Texas or MSW * Must deal calmly and effectively with high stress situation. * Two (2) or more years of medical or psychiatric case mangement or utilization experience. * Medical Terminology * Three to Five years' case management experience in a hospital setting preferred. * Minimum of three years' experience in an acute care setting. * Knowledge of Texas Medical Foundation Criteria. * Knowledge of Interqual Screening Criteria. Your Shift: Full Time Days/Monday-Friday LHSH Incentives * Flexible Scheduling * No mandatory overtime * Career Ladder Lubbock Heart & Surgical Hospital specializes in the care of cardiac, orthopedic, nephrology, urology, and general medical patients. We are also a highly active inpatient center mainly centered on surgical procedures that include cardiothoracic, orthopedic, urology, and general surgery. We have a 24-hour Emergency Department with 5 fully equipped ED rooms, 4 fully operating OR rooms, 4 cardiac catherization labs with 1 electrophysiology room, 11-day surgery rooms, 58 acute care beds spread over three units, and 16 cardiac critical care rooms. We pride ourselves on giving the best overall care possible to our patients and on our family style atmosphere that includes everyone: patients and their families, physicians, and our employees.

  • RN Case Manager/UR Reviewer

    3 weeks ago

    Lubbock, United States Lubbock Heart Hospital Full time

    RN Case Manager/UR ReviewerJOIN OUR TEAM!!! Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

  • RN Case Manager/UR Reviewer

    2 weeks ago

    Lubbock, United States Lubbock Heart Hospital Full time

    RN Case Manager/UR Reviewer JOIN OUR TEAM Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

  • RN Case Manager/UR Reviewer

    2 weeks ago

    Lubbock, United States Lubbock Heart Hospital Full time

    RN Case Manager/UR ReviewerJOIN OUR TEAM!!! Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

  • RN Case Manager/UR Reviewer

    3 weeks ago

    Lubbock, TX, United States Lubbock Heart Hospital Full time

    RN Case Manager/UR ReviewerJOIN OUR TEAM!!! Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

  • RN Case Manager/UR Reviewer

    2 weeks ago

    Lubbock, TX, United States Lubbock Heart Hospital Full time

    RN Case Manager/UR ReviewerJOIN OUR TEAM!!! Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

  • RN Case Manager/UR Reviewer

    3 weeks ago

    Lubbock, TX, United States Lubbock Heart Hospital Full time

    Are you looking for a positive work environment where teamwork and diversity are key? Every role in our hospital has an impact on each of our patients. Because we're physician-owned, we understand the value of having a well-trained, well-resourced staff. When it comes to procedural healthcare, experience matters. Lubbock Heart & Surgical Hospital is...

  • RN Case Manager 32HRW

    3 weeks ago

    Houston, TX, United States Erickson Living Full time

    RN Case Manager 32HRW Location: Eagle's Trace by Erickson Senior Living Eagle's Trace is a beautiful 70-acre continuing care retirement community located just minutes from the metroplex in West Houston, Texas. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider of senior living...

  • Senior Director, Utilization Review

    1 week ago

    Dallas, TX, United States Other Executive Full time

    Under the direction of the VP of Case Management & Continuing Care, the Sr. Director of Utilization Review (UR) is responsible for overseeing the development, implementation, and performance management of Utilization Review services performed across the Tenet enterprise. Leads Tenet Hospital case management operations to develop and implement centralized...

  • RN Case Manager 32HRW

    3 weeks ago

    Houston, TX, United States Erickson Living Full time

    RN Case Manager 32HRWLocation: Eagle's Trace by Erickson Senior Living Eagle's Trace is a beautiful 70-acre continuing care retirement community located just minutes from the metroplex in West Houston, Texas. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider of senior living and health care...

  • RN Case Manager 32HRW

    3 weeks ago

    Houston, TX, United States Erickson Living Full time

    Eagle's Trace by Erickson Senior Living Eagle's Trace is a beautiful 70-acre continuing care retirement community located just minutes from the metroplex in West Houston, Texas. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider of senior living and health care with campuses in 11 states-and...

  • Case Manager RN

    3 weeks ago

    Houston, TX, United States Kindred Hospital Houston Medical Center Full time

    Case Manager RN At Kindred It Starts With Me. Our commitment is to deliver excellence and an empathetic human experience to every patient, every family member, every employee, every time. We do this through our Core Values which help in guiding our work every day. Job Summary: The Case Manager II coordinates and facilitates the care of the patient...

  • Travel Nurse RN

    3 weeks ago

    Austin, TX, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Austin, Texas. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 10 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse for...

  • Case Manager II, RN

    3 weeks ago

    Arlington, TX, United States Kindred Hospital Tarrant County Arlington Full time

    Case Manager II, RN Job Summary Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review...

  • RN Case Manager

    3 weeks ago

    San Antonio, TX, United States UT Health San Antonio Full time

    RN Case ManagerManages cases to enhance the quality of patient management and satisfaction. Promotes continuity of care and cost effectiveness through integrating functions of case management, utilization review and management, and discharge planning.

  • Case Manager RN

    3 weeks ago

    Houston, TX, United States Kindred Hospital Houston Medical Center Full time

    Case Manager RNAt Kindred It Starts With Me. Our commitment is to deliver excellence and an empathetic human experience to every patient, every family member, every employee, every time. We do this through our Core Values which help in guiding our work every day. Job Summary: The Case Manager II coordinates and facilitates the care of the patient...

  • In-Patient Case Manager RN

    3 weeks ago

    Harlingen, TX, United States UnitedHealth Group Inc Full time

    In-Patient Case Manager RN Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a...

  • Case Manager II, RN

    3 weeks ago

    Arlington, TX, United States Kindred Hospital Tarrant County Arlington Full time

    Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support...

  • Travel Nurse RN

    3 weeks ago

    Round Rock, TX, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Round Rock, Texas. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/10/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...

  • Travel Nurse RN

    3 weeks ago

    El Paso, TX, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in El Paso, Texas. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/10/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...

  • RN Case Manager

    3 weeks ago

    Dallas, TX, United States University of Texas Southwestern Medical Center Full time

    RN Case Manager RN Case Manager Full Time Days M-F 8 hour shifts on-site New Hires may be eligible for a $5,000 sign on bonus! Why UT Southwestern? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to...