RN Case Manager I FT Days: Delivering Comprehensive Patient Care

3 weeks ago

Tucson, Arizona, United States Carondelet St. Josephs Hospital Full time

Welcome to Carondelet Health Network, a healthcare provider that is dedicated to making a meaningful difference in people's lives. Our organization believes in the power of genuine connections and heartfelt compassion, which sets us apart from others.

We are seeking an experienced RN Case Manager I to join our team on a full-time basis, working days. This role is responsible for facilitating 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 patient's resources and right to self-determination.

The RN Case Manager I will be responsible for ensuring that care is provided at the appropriate level of care based on medical necessity and assessing patients 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, transition management, care coordination, compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy, as well as providing education to physicians, patients, families, and caregivers.

Key responsibilities include:

  • 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
  • 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 completion and concise documentation in Case Management system
  • Maintenance of accurate patient demographic and insurance information
  • Identification and documentation of potentially avoidable days
  • Identification and reporting over and underutilization

To succeed in this role, the ideal candidate should possess the following qualifications:

  • RN licensure, certified, or registered to practice profession as required by law or regulation in the state of practice or policy
  • Active RN license for the covered state(s)
  • Prior experience in acute hospital patient care, preferably with a focus on case management

This opportunity offers a competitive salary of around $120,000 per year, depending on location and experience, as well as opportunities for professional growth and development within a reputable healthcare organization.

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