RN Case Manager

16 hours ago


Memphis, Tennessee, United States Baptist Memorial Full time
Job Summary

As a RN-Case Manager at Baptist Memorial Health Care, you will play a vital role in managing the care for a specific population, ensuring the safe transition of patients throughout the continuum of care. Your expertise will be utilized to facilitate the appropriate utilization of resources, service delivery, and compliance with federal and other payer requirements.

Key Responsibilities
  • Utilization Review: Conduct thorough reviews to ensure the most effective use of resources and services.
  • Discharge Planning: Collaborate with patients, families, and healthcare teams to develop personalized discharge plans.
  • Readmission Reduction Participation: Identify and address potential readmission risks to improve patient outcomes.
  • Payer Communication and Denial Reduction: Effectively communicate with payers to reduce denials and ensure timely reimbursement.
  • Completes Assigned Goals: Meet or exceed performance metrics and goals.
Requirements, Preferences, and Experience

We are seeking a highly skilled and experienced RN with a strong background in case management. The ideal candidate will possess:

  • Preferred: BSN or MSN degree
  • Minimum: Diploma or Associate Degree in Nursing
  • Preferred: 3 years of clinical experience with case management experience in a hospital or payer setting
  • Minimum: 1 year of clinical experience
  • Preferred: RN;CCM;ACM certifications
  • Minimum: RN licensure
Special Skills

The successful candidate will possess excellent critical thinking, communication, organization, interpersonal, and computer skills, as well as knowledge of payer requirements, problem-solving, and governmental regulations.

About Baptist Memorial Health Care

We are a faith-based, not-for-profit health care organization dedicated to providing compassionate care to our patients and communities. Our team is committed to excellence, and we offer a competitive compensation and benefits package, including:

  • Competitive salaries
  • Paid vacation/time off
  • Continuing education opportunities
  • Generous retirement plan
  • Health insurance, including dental and vision
  • Sick leave
  • Service awards
  • Free parking
  • Short-term disability
  • Life insurance
  • Health care and dependent care spending accounts
  • Education assistance/continuing education
  • Employee referral program


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