RN Case Manager Pinecrest Rehab Full Time Days

Summary

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention, and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; Education provided to physicians, patients, families and caregivers.

The Registered Nurse / RN Case Manager is a nurse with strong clinical knowledge and leadership skills. The Registered Nurse / RN Case Manager collaborates with the patient, family, physician, interdisciplinary team, and payer representative to assess, plan, implement, coordinate, monitor and evaluate options and services to promote optimal patient outcomes. The Registered Nurse / RN Case Manager monitors the provision of cost-effective care to ensure care is given in the most clinically appropriate setting. The Registered Nurse / RN Case Manager facilitates compliance with regulatory requirements and organizational performance standards.