Summary

The individual in this position has overall responsibility for coordinating the daily activities of the case management team, while overseeing the clinical plan of care to conform with evidence-based practice and/or regulatory/payor requirements.
This position integrates functions typically considered to be case management, care coordination and/or utilization management, and discharge planning assessment and coordination.

Responsibilities

As such, the individual�s responsibilities will include, but not be limited to the following activities:

• Coordination of clinical care (medical necessity, appropriateness of care and resource utilization for admission, continued stay, discharge and post-acute care) compared to evidenced-based practice, internal and external requirements.
• Identify and report variances in appropriateness of medical care provided, over/under utilization of resources compared to evidenced-based practice and external requirements.
• This priority includes work with relevant software and communicating information through clear, complete and concise documentation in CM software.
• Effective collaboration with physicians, nurses, ancillary staff, payors, patients and families to achieve optimum clinical outcomes.
• Remain current with relevant clinical / case management practices.
• Assist Director with daily operational oversight and supervision of Departmental staff.

Education

Required:
Preferred: Bachelor of Science in Nursing (BSN) preferred.

Experience

Required: Two (2) years acute hospital case management, healthcare or leadership experience. McKesson InterQual© experience preferred. Five years (5) acute hospital case management experience preferred.

Certifications

Required: Active Registered Nurse license.
Preferred: Accredited Case Manager (ACM)

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Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.