What are the responsibilities and job description for the Clinical Nurse Specialist position at Baptist Memorial Healthcare Corporation?
About the Role
">The RN-Case Manager is a critical member of our team, responsible for managing the care of a specific population and facilitating safe transitions throughout the continuum of care. This role requires strong communication, organizational, and problem-solving skills, as well as knowledge of payer requirements and governmental regulations.
Key Responsibilities
">- Utilization Review: Ensure appropriate resource utilization and service delivery to meet patient needs.
- Discharge Planning: Coordinate safe and timely discharges, taking into account patient preferences and circumstances.
- Readmission Reduction Participation: Collaborate with multidisciplinary teams to identify and address readmission risk factors.
- Payer Communication and Denial Reduction: Effectively communicate with payers to reduce denial rates and ensure timely reimbursement.
Requirements and Qualifications
">- Education: BSN or MSN preferred; diploma or associate degree in nursing minimum.
- Experience: 3 years of clinical experience with case management experience in a hospital or payer setting preferred; at least one year of clinical experience minimum.
- Licensure and Certification: RN licensure required; CCM or ACM certification preferred.
About Baptist Memorial Healthcare Corporation
">We are a healthcare organization that values compassion, expertise, and community involvement. Our mission is to improve the health and wellness of those we serve, guided by our commitment to excellence and Christ's three-fold ministry - healing, preaching, and teaching.
Benefits
">- Competitive Salaries
- Paid Vacation/Time Off
- Continuing Education Opportunities
- Generous Retirement Plan
- Health Insurance
- Sick Leave
- Service Awards
- Free Parking
