RN, Registered Nurse Care Manager- Utilization Review
Location: Tyler, Texas
Internal Number: 14865601
The RN Care Manager (CM) II works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. The CM ensures that the patient is progressing toward desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Assesses and responds to patient/family needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care. The CM plans effectively to meet patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement
BSN Degree from an accredited nursing program or demonstrated success in CHRISTUS RN Care Manager I position
Excellent verbal and written communication
Critical and analytical thinking skills
Demonstrated clinical competency
Working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
Understanding of pre-acute and post-acute levels of care and community resources
Ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families
Three or more years clinical experience in clinical practice or demonstrated success in CHRISTUS RN Care Manager I position
Case management and Utilization Review experience preferred
Licenses, Registrations, or Certifications
RN License in state of employment or compact required
Certification in Case Management or demonstrated success in CHRISTUS RN Care Manager I Position
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CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.