RN-Case Manager

1 week ago


Jonesboro, Arkansas, United States Baptist Memorial Healthcare Corporation Full time
Job Summary

We are seeking a skilled RN-Case Manager to join our team at Baptist Memorial Health Care Corporation. As a RN-Case Manager, you will play a critical role in managing the care for a specific population, facilitating the safe transition of patients throughout the continuum of care, and ensuring appropriate utilization of resources, service delivery, and compliance with federal and other payer requirements.

Responsibilities
  • Utilization Review: Conduct thorough reviews of patient records to ensure accurate and efficient use of healthcare resources.
  • Discharge Planning: Develop and implement individualized discharge plans to ensure a smooth transition of care for patients.
  • Readmission Reduction Participation: Collaborate with healthcare teams to identify and address factors contributing to readmissions.
  • Payer Communication and Denial Reduction: Effectively communicate with payers to resolve billing and payment issues.
  • Completes Assigned Goals: Meet or exceed performance metrics and goals.
Requirements, Preferences, and Experience
  • Education: BSN or MSN preferred; Diploma or Associate Degree in Nursing minimum.
  • Experience: RN with 3 years of clinical experience and Case Management experience in a hospital or payer setting preferred; RN with at least one year of clinical experience minimum.
  • Licensure, Registration, Certification: RN; CCM; ACM preferred; RN minimum.
  • Special Skills: Critical thinking skills, communication, organization, interpersonal, and computer skills; knowledge of payer requirements, problem-solving, and governmental regulations.
About Baptist Memorial Health Care Corporation

We offer a competitive compensation and benefits package, including paid vacation/time off, continuing education opportunities, generous retirement plan, health insurance, and more. Join our team and be part of an organization that values its employees and provides opportunities for growth and development.



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