Arizona Specialty Hospital is seeking an experienced Registered Nurse Case Manager to join our team! This position is full time.
The RN Case Manager responsibilities include:
- Working independently while handling multiple priorities simultaneously.
- Utilizes the nursing process of assessment, planning, implementation and evaluation to direct or provide nursing care.
- Manages patients across the healthcare continuum to achieve optimal clinical, financial, operational and satisfaction outcomes.
- Assess the patients’ plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care.
- Active participant in the interdisciplinary healthcare team to promote/facilitate discharge planning, facilitating options and services to meet patients’ health care needs.
- Identifies and intervenes when necessary to ensure efficient and cost-effective delivery of patient care services.
- Coordinates the necessity of case management and utilization review for any patient at AZSH.
- Provides requested documentation to payors in a timely manner.
- Establishes and promotes collaborative relationships with physicians, patients, families and additional members of the healthcare team.
- Educates members of the healthcare team on case management and managed care concepts.
- Review medical necessity and coordinate with the interdisciplinary team to assure correct status for payment.
- Assist with clinical interpretation for denial and appeals management.
- Knowledgeable about Medicare, Medicaid, and commercial insurance plans.
- Strong analytical, organizational, and time management skills.
- Experience with InterQual and or MCG.
- EMR Experience.
Required Skills:Benefits:
- Medical, Dental, Vision
- PTO and Sick time Plans
- 401k after 30 days
- Employer Paid Life Insurance
- Employee Paid Life Insurance
- and more!
Requirements
- Unencumbered RN license
- Hospital experience preferred
Required Experience: - Current unencumbered RN license
- Recent Case Management experience in a hospital setting
- Utilization review experience
- Discharge planning in a hospital setting
- Ability to be part of the RN Case Management On Call rotation, with 1-2 on call weekends a month, depending on case load.
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