Case Management RN Supervisor
1 day ago
Job Summary:
As a Manager of Case Management RN, you will oversee the coordination of medical services and discharge planning for a specified patient population. Your role will involve reviewing patient medical records for utilization review, compliance with external review agencies, and quality assurance. You will promote a cooperative relationship with patients, families, facility staff, physicians, and community agencies.
Key Responsibilities:
- Communicate with Patient Access, Patient Account Services, and Central Verification Office personnel to ensure proper pre-certification and consistency of admissions status designation.
- Communicate changes to patient payer information and other relevant financial characteristics to admissions and billing personnel.
- Ensure required clinical justification is provided to third-party payers for recertification and transfer of information to PAS and CVO.
- Serve as a liaison between third-party payers, patient access, PAS, and CVO to ensure communication of all pertinent information regarding level of care, billing, and reimbursement.
- Work with patients and families to identify alternate financial resources or recommend alternate care options when necessary.
Requirements:
- RN licensure in the state of TX or Compact State.
- Associates Degree or BSN completion within 3 years of hire date.
- Minimum 2 years of Case Management experience in the acute care setting.
Benefits:
All Standards benefits are covered.
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