What are the responsibilities and job description for the Case Manager / RN position at The University of Kansas Health System St. Francis Campus?
Overview
Join our team as a day shift, PRN, Case Management Acute Care, Case Manager Registered Nurse in Topeka, Kansas.
Thrive in a People-First Environment and Make Healthcare Better
- Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being.
- People-First: We prioritize your well-being with a supportive, inclusive culture where you are valued and cared for.
- Make Healthcare Better: We use advanced technology to support our team and enhance patient care.
Get to Know Your Team:
- The University of Kansas Health System St. Francis Campus, a part of a rich legacy of compassionate care since 1909, now offers 378 licensed beds, a history of innovation, and strong community support.
Responsibilities
- The Case Manager coordinates care for high risk/complex patients and families by collaborating with the patient, family, physician, nurses, and other members of the healthcare team to identify needs and expedite appropriate, cost effective care.
- Advises the healthcare team and provides leadership in issues of outcomes management and development of improved strategies to benefit high risk patients.
- Provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type.
- Provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent and retrospective reviews.
- Intervenes when potential denials are determined and files appeals when denials are received.
- Partners with physician related to resource utilization including LOS and cost per case.
- Reports to the Clinical Resource Management Director.
Qualifications
Job Requirements:
- Current licensure by Kansas State Board of Nursing.
- Minimum of 3 years as a professional nurse in direct patient care with demonstrated clinical expertise.
- RN,
- BLS
Preferred Job Requirements:
- BSN
- Current certification as a Care Assessor for the State of Kansas or obtain within 6 month of hire.
- Previous experience as a case manager or utilization review nurse.
