Nurse Case Manager

2 days ago


Tucson, Arizona, United States Tenet-AZ Region Full time

Tenet-AZ Region is seeking a skilled Nurse Case Manager to join their team in Tucson, Arizona.

Job Summary

The Nurse Case Manager will be 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.

Key Responsibilities
  • Accurate medical necessity screening and submission for Physician Advisor review
  • Care coordination and 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 and 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, complete, 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
Requirements

The ideal candidate will possess the following education, licensure/certification, and experience:

  • Graduate of an accredited school of nursing
  • Academic degree in nursing (bachelor's or master's)
  • Currently licensed, certified, or registered to practice profession as required by law or regulation in state of practice or policy
  • Active RN license for state(s) covered
  • Accredited Case Manager (ACM)
  • 3 years of department experience or 4 years of acute hospital case management experience

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