299 rn utilization review inpatient case manager days jobs found

Overview The Care Coordinator RN Sr. (RN Sr) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met the most complex cases during the patient's acute admission. The RN Sr requires strong clinical expertise to partner with physicians and care teams to drive optimal and efficient treatment plans to streamline progression of care while in the hospital, as well as, planning for post discharge care. The RN Sr will serve as an expert resource and consultant to the other team members in regards to care progression and assisting in planning to effectively meet the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care progression and transitional care planning functions. Specific functions within this role include: Transitional care planning, clinical care progression,...

Job Description: The Nurse Case Manager utilizes clinical expertise and critical thinking skills to develop and implement a plan of care that provides cost effective, extraordinary care. This position works collaboratively with patients, patient families/significant others, healthcare providers, insurers, community resources, and other involved parties.     Job Essentials Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Completes documentation as required. Performs utilization review activities to provide patient appropriate, timely, and cost effective care. Coordinates care with patient, care providers, hospital financial services, and third-party payers. Maintains an active role in denial prevention. Proactively intervenes with payers to prevent inpatient denials. Performs retroactive reviews on discharged patients as assigned. Communicates any necessary information to payers to...

200751 RTOC - Renown Transfer & Operations Center Reno , NV   Full Time - Eligible for Benefits , Day , 8-1630 Nursing Posted 08/14/2023 Req # 175413 Biweekly Hours: 80 Position Purpose This position promotes appropriate utilization, high quality care and cost effective outcomes. Incumbent is also responsible for utilization review, coordination of acute inpatient denials, performing admission and concurrent reviews and communication with physicians and payers regarding the medical necessity for services.       Nature and Scope Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines approved by medical staff to...

Description Medical City Weatherford Registered Nurse Case Manager Days PT Work Schedule:   Part-time, weekend coverage Saturday and Sunday 8:00am - 4:30pm + one additional weekday (typically Monday or Friday)   Introduction Are you looking for a place to deliver excellent care patients deserve? At Medical City Weatherford we support our colleagues in their positions. Join our Team as a(an) RN Case Manager and access programs to assist with every stage of your career. Benefits Medical City Weatherford offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and...

Description Medical City Weatherford Registered Nurse Case Manager Days PT Work Schedule:   Part-time, weekend coverage Saturday and Sunday 8:00am - 4:30pm + one additional weekday (typically Monday or Friday)   Introduction Are you looking for a place to deliver excellent care patients deserve? At Medical City Weatherford we support our colleagues in their positions. Join our Team as a(an) RN Case Manager and access programs to assist with every stage of your career. Benefits Medical City Weatherford offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and...

Description RN Case Manager- Case Management-MSH-Days FT The Case Manager (CM) will be responsible for all aspects of case management for an assigned group of inpatients to determine the appropriateness of the admission and continued stay, assist in the development of the plan of care; ensure that the plan is implemented in a timely basis and identify the expected length of stay (ELOS).  The CM works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary team as needed.  The CM actively participates in specific clinical initiatives focused on reducing the length of stay (LOS), improved efficiency, quality, and resource utilization.  Assignment will be by units/clinical areas of practice and may require responsibility on other units/services.

Organization: SMCS-Valley Administration Position Overview: Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self –determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies,...