Registered Nurse Case Manager Full Time Days
| Company | Tenet Healthcare |
|---|---|
| Location | Detroit, MI, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Mid Level, Senior |
Requirements
- Graduate from an accredited school of nursing.
- Bachelors degree in Nursing or other health-related field, or equivalent combination of education and/or related experience.
- Two years of acute hospital patient care experience.
- License to practice as a Registered Nurse in the State of Michigan.
- Must complete Tenets InterQual education course within 30 days of hire (and at least annually thereafter) and pass with a score of 85 or better.
- Must complete and demonstrate competency in using the Tenet Case Management documentation system within 30 days of hire.
Responsibilities
- Accurate medical necessity screening and submission for Physician Advisor review.
- Care coordination.
- 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.
- 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.
Preferred Qualifications
- Acute hospital case management experience preferred.
- Accredited Case Manager (ACM) preferred.