Case Manager

3 weeks ago


Topeka, United States UKHS St. Francis Campus Full time
Overview

You may be eligible for a Sign On Bonus of up to $5,000.00

Join our team as a day shift, full-time, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas.

Fulfilling your purpose begins here:

People First, Always. Here's how we take care of our people:

  • Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more.

Your team is bigger than your department:

  • The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support.
  • We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.
Responsibilities
  • The Case Manager coordinates care for high risk/complex patients and families by collaborating with the patient, family, physician, nurses, and other members of the healthcare team to identify needs and expedite appropriate, cost effective care.
  • Advises the healthcare team and provides leadership in issues of outcomes management and development of improved strategies to benefit high risk patients.
  • Provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type.
  • Provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent and retrospective reviews.
  • Intervenes when potential denials are determined and files appeals when denials are received.
  • Partners with physician related to resource utilization including LOS and cost per case.
  • Reports to the Clinical Resource Management Director.

Qualifications

Job Requirements:

  • Current licensure by Kansas State Board of Nursing.
  • Minimum of 3 years as a professional nurse in direct patient care with demonstrated clinical expertise.
  • RN,
  • BLS

Preferred Job Requirements:

  • BSN
  • Current certification as a Care Assessor for the State of Kansas or obtain within 6 month of hire.
  • Previous experience as a case manager or utilization review nurse.

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