LEAD CASE MGR (RN)

Case Management Lead position would be responsible for assisting Director of Case Management and Chief Financial Officer on admissions, concurrent and retrospective medical reviews of all patient populations for documentation of appropriateness of admission and continued stay. This position requires close collaboration and communication with payers to reduce risk of denials. This includes the initiation of interventions to reduce and eliminate avoidable days, opportunity days and delays in care; works in collaboration with interdisciplinary team members internal and external to the organization; participates in process improvement and evaluation process related to the management of patient care and resource utilization. Works in close collaboration with the assigned SW/DCP on the floor for timely patient assessments for identification and arrangement of patient discharge needs, to ensure timely transition of patients to the next level of care. Additional responsibilities include training of any new RN CM staff, and managing certain special projects as needed.

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We believe that diversity and inclusion among our teammates is critical to our success.

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Diploma or Associates degree from an accredited Registered Nursing program. BSN preferred. Texas RN license required.

Minimum of 2 years of experience in an acute care case management role preferred. Knowledge of private insurance, Medicare criteria for hospitalization, understanding of healthcare financial systems, benchmarking practices. Experience in facilitating change through interdisciplinary collaboration; computer skills.

BLS preferred.