Description

St. Francis Hospital Memphis

Saint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women’s Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/ Surge and Telemetry.

Case Manager RN PRN Days Position Summary

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:

Utilization Management supporting medical necessity and denial preventionTransition Management promoting appropriate length of stay, readmission prevention and patient satisfactionCare Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of careCompliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policyEducation provided to physicians, patients, families and caregivers

Responsibilities

The individual’s responsibilities include the following activities:

Accurate medical necessity screening and submission for Physician Advisor review,Care coordination;Transition planning assessment and reassessmentImplementation or oversight of implementation of the transition planLeading and facilitating multi-disciplinary patient care conferences, Managing concurrent disputes, Making appropriate referrals to other departments, Identifying and referring complex patients to Social Work ServicesCommunicating with patients and families about the plan of careCollaborating with physicians, office staff and ancillary departmentsLeading and facilitating Complex Case ReviewAssuring patient education is completed to support post-acute needsTimely complete and concise documentation in Case Management systemMaintenance of accurate patient demographic and insurance informationIdentification and documentation of potentially avoidable daysIdentification and reporting over and underutilization;Other duties as assigned

Education

Required: Graduate of an accredited school of nursing.

Preferred: Academic degree in nursing (bachelor's or master's)

Experience

Required: 2 years of acute hospital patient care experience.

Preferred: Acute hospital case management experience.

Certification

Required: RN. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.

Preferred: Accredited Case Manager (ACM)

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