at AHS Kansas Health System in Topeka, Kansas, United States
Job Description
Overview
Join our team as a day shift, part-time, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas.
Fulfilling your purpose begins here:
People First, Always. Here's how we take care of our people:
Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more.
Your team is bigger than your department:
The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support.
We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.
Responsibilities
The Case Manager coordinates care for high risk/complex patients and families by collaborating with the patient, family, physician, nurses, and other members of the healthcare team to identify needs and expedite appropriate, cost effective care.
Advises the healthcare team and provides leadership in issues of outcomes management and development of improved strategies to benefit high risk patients.
Provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type.
Provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent and retrospective reviews.
Intervenes when potential denials are determined and files appeals when denials are received.
Partners with physician related to resource utilization including LOS and cost per case.
Reports to the Clinical Resource Management Director.
Qualifications
Job Requirements:
Current licensure by Kansas State Board of Nursing.
Minimum of 3 years as a professional nurse in direct patient care with demonstrated clinical expertise.
RN,
BLS
Preferred Job Requirements:
BSN
Current certification as a Care Assessor for the State of Kansas or obtain within 6 month of hire.
Previous experience as a case manager or utilization review nurse.
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