Baptist Memorial
Location
Jackson, MS | United States
Job description
Summary
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities
Provides clinical review and utilization management for all payers utilizing criteria and other payer based tools.
Maintains communication with patient and/or family on an ongoing basis. Communicates in person as often as necessary to maintain an agreed upon discharge plan of care.
Collaborates with the health care team on an ongoing basis to promote a smooth and effective transition/discharge.
Assists in monitoring of readmission rates and identifying opportunities for improvement.
Provides timely information and coordination to reduce denial opportunities by payers.
Completes assigned goals.
Requirements, Preferences and Experience
Education
Preferred: Bachelor's in Nursing
Minimum: Diploma or Associate Degree in Nursing
Experience
Preferred: RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Minimum: RN with 2 years of clinical experience
Licensure, Registration, Certification
Preferred: RN;CCM;ACM
Minimum: RN
Special Skills
Preferred: Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Minimum: Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Training
Preferred: 3 years of clinical experience with Case Management experience in a hospital or payer setting
Minimum: 2 years of clinical experience
About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer:
Competitive salaries
Paid vacation/time off
Continuing education opportunities
Generous retirement plan
Health insurance, including dental and vision
Sick leave
Service awards
Free parking
Short-term disability
Life insurance
Health care and dependent care spending accounts
Education assistance/continuing education
Employee referral program
Job Summary:
Position: 11344 - RN-Case Manager
Facility: MBMC-Hospital
Department: JS Case Management Administration MBMC
Category: Nurse RN
Type: Non Clinical
Work Type: PRN
Work Schedule: Days
Location: US:MS:Jackson
Located in the Jackson, MS metro area REQNUMBER: 3967
Job tags
Salary
