Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities
- Utilization Review and precertification
- Discharge planning
- Readmission Reduction Participation
- Payer Communication and denial reduction
- Completes assigned goals.
- Provides direction and guidance to others regarding practice, serves as resource, preceptor and mentor. Leadership skills demonstrated in decision making and problem solving.
Requirements, Preferences and Experience Education Preferred: BSN or MSN
Minimum: Diploma or Associate Degree in Nursing
Experience Preferred: RN with 5 years of clinical experience with Case Management experience in a hospital or payer setting
Minimum: RN with 3 years of clinical experience
Licensure, Registration, Certification Preferred: RN;CCM;ACM
Minimum: RN
Special Skills Preferred: Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Minimum: Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Training Preferred: Certified Case Manager
About Baptist Memorial Health Care At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer:
- 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
Job Summary: Position: 20064 - RN-Case Manager Lead
Facility: BMH - Women's Hospital
Department: WH Case Management Admin BMH Women's
Category: Nurse RN
Type: Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area
