RN Case Manager

7 days ago

Fort Worth, Texas, United States Palm Medical Centers Full time
Palm Medical Centers Seeks Experienced RN Clinical Coordinator

Palm Medical Centers, a rapidly growing healthcare organization, is seeking an experienced RN Clinical Coordinator to join our team. As a key member of our Utilization Management Department, you will play a vital role in coordinating patient care and ensuring seamless transitions between hospital and nursing home settings.

Key Responsibilities:
  • Admit new patients by reviewing records and applications, and conduct orientations to ensure a smooth onboarding process.
  • Communicate daily tracking of hospital and nursing home admissions and discharges for statistical and cost management purposes.
  • Determine patient requirements by completing intake interviews and assessing the need for therapeutic medical, psycho-social, and psychiatric evaluations.
  • Establish treatment programs by setting schedules and routines, coordinating services, and arranging resources, including transportation and escort.
  • Monitor cases by verifying client attendance, observing and evaluating treatments, and advocating for needed services and entitlements.
  • Maintain accurate records by reviewing case notes, logging events, and tracking progress.
  • Collaborate with PMC managers to ensure appropriate medical care follow-up for discharged patients.
  • Identify potential catastrophic and stop-loss patients, and coordinate transfers as instructed by the Medical Director or PCP.
  • Arrange direct admissions to hospitals and placement in nursing homes, and assist PCPs in placing patients at SNFs.
  • Monitor length of stay (LOS) for hospital and nursing home patients and make necessary discharge arrangements.
Requirements:
  • Proven experience in case management, including as an RN, medical, mental health care manager, or related job experience.
  • Excellent knowledge of case management principles, management, and reimbursement.
  • Previous experience with psychological aspects of care.
  • Effective communication and organizational skills.
  • Problem-solving skills and ability to multitask.
  • Compassionate and team-oriented approach.
  • Knowledge of CPT codes and ICD-10 terminology.
  • Bilingual preferred.
  • Knowledge of InterQual or Milliman Care Guidelines preferred.
Minimum Qualifications:
  • Active TX RN license.
  • Minimum 3 years of RN Clinical Coordinator experience.
Benefits:
  • 401(k) plan.
  • Dental insurance.
  • Employee assistance program.
  • Flexible spending account.
  • Health insurance.
  • Life insurance.
  • Paid time off.
  • Vision insurance.
Work Schedule:
  • Day shift.
  • Monday to Friday.
Relocation:
  • Fort Worth, TX.

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