What are the responsibilities and job description for the RN Case Manager FT Days position at Saint Francis Hospital - Memphis?
St. Francis Hospital Memphis
Saint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women’s Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/ Surge and Telemetry.
RN Case Manager Full Time Days Position 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
Responsibilities
The individual’s responsibilities include the following activities:
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;
Other duties as assigned
Education
Required: Graduate of an accredited school of nursing.
Preferred: Academic degree in nursing (bachelor's or master's)
Experience
Required: 2 years of acute hospital patient care experience.
Preferred: Acute hospital case management experience.
Certification
Required: RN. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.
Preferred: Accredited Case Manager (ACM)
