Description SHIFT: Days (rotating weekends) SCHEDULE: Full-time Medical City Dallas RN - Registered Nurse - Case Manager Full Time Observation - Utilization Review POSITION SUMMARY The RN Case Manager works with physicians and other members of the multidisciplinary team to develop a plan for each patient from admission to discharge. The tasks and responsibilities include: Performs continuous assessments and evaluations to ensure patient is progressing towards desired outcomes Assesses and responds to patient/family needs by coordinating efforts of other team members Identifies and resolves barriers that hinder effective patient care Collaborates and consults with physicians on patient's progress and discharge planning needs Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity Manages the process to review and, as appropriate, appeal denials received from payors Coordinates the discharge planning process ensuring involvement of all members of the healthcare team Counsels with patients and family members in decision making and in meeting psycho-social needs of the patient Maintains knowledge of resources and facilities available to patients and family members Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions Compiles, evaluates, and reports statistics to members of the team and utilizes the information to facilitate process improvement activities Provides age and culturally appropriate care Orients and mentors new staff members Medical City is a very \"special\" ANCC Magnet medical center located in far North Dallas that is designed with the health and well-being of the entire family. Prevention of disease is our focus, but treatment, when necessary is by some of the most highly specialized physicians in the country. In fact, patients travel to Medical City from over 75 countries and from all over the United States for the sophisticated treatment offered by some of its 400+ in-house physician specialists....where they have access to the latest and most sophisticated technology. Over 95 different medical and surgical sub-specialists are housed within the \"City\". Our medical center offers a full service adult and pediatric hospital, with separate adult and pediatric emergency rooms, outpatient centers, and a psychiatric hospital. Being recognized for their excellence in patient care, Medical City has received numerous awards including the Joint Commission's highest honor bestowed to hospitals in the United States Why work for HCA: Click the Link to find out more about our Benefits and what our employees have to say about working with Medical City. Utilization Review, Interqual, Criteria set, Observation reviews Qualifications POSITION QUALIFICATIONS Current Texas RN License or Valid compact license BSN preferred, required within 24 months CCM preferred Minimum 5 years of clinical nursing experience required Knowledge of CMS guidelines and experience working with payor-specific guidelines and contractual rules preferred Customer service abilities including effective listening skills Critical thinking skills, decisive judgment and the ability to work with minimal supervision meeting firm deadlines Assertive and persuasive communication skills, action oriented
Associated topics: ambulatory, asn, care, care unit, intensive care, neonatal, registed, surgery, tcu, transitional
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.