RN Case Manager
Company: Surgery Partners
Posted on: January 24, 2023
DescriptionShift: / Full Time Days with Rotating Call
Registered nurses (RNs) who must have the ability to develop,
implement, and evaluate individualized patient care plans. Duties
include utilization review, case management, and discharge
planning, advocating for patient welfare, and serving as a liaison
between patients, their families, and healthcare providers. Reviews
medical records concurrently for concurrent discharge planning,
length of stay, and insurance and managed care reviews. Works with
patients and their families to establish post-hospital care.
- * Reviews medical records concurrently for appropriateness of
level of care and discharge planning.
* Reviews medical records concurrently for insurance and managed
* Reviews all patient admission data on a concurrent basis within
the designated time frames to determine the suitability of the
level of care in accordance with Texas Medical Foundation and/or
* Collaborates with the attending physician if the case does not
meet admission or continued stay criteria. Refers unresolved issues
and questionable reviews to the Director of Case
* Documents all utilization review activity on the appropriate
* Develops and maintains an effective working relationship with
physicians and staff.
* Works with patients and families to identify resources and
additional avenues for post-hospital care and support.
* Coordinates with nursing to help with discharge teaching.
* Works with other agencies to identify placement, transportation,
funding, medications, and other protocols as needed in a cost
* Prepares and maintains essential records and reports.
* Assures a sage and therapeutic environment for patients and
* Identifies and implements actions to improve clinical
* Organizes time and sets priorities to accomplish work load.
* Deals with conflict and problematic situations in an open,
respectful, and tactful manner.
* Supports, assists, and adheres to implementation of the
organization mission and vision.
* Organizes use of resources to assure efficient operation.
MINIMUM KNOWLEDGE AND SKILLS REQUIRED
- Three to Five years' case management experience in a hospital
* Minimum of three years' experience in an acute care setting.
* Knowledge of Texas Medical Foundation Criteria.
* Knowledge of Interqual Screening Criteria.
* Know the definitions of fundamental computer terms related to
applications software and desktop PC's
* Know how to open, read, and respond to email
* Know how to manage electronic files
* Know how to print electronic documents and reports
MINIMUM EDUCATION AND EXPERIENCE REQUIRED
- Graduation from an approved Nursing program, Bachelor Degree in
LICENSURE AND CERTIFICATION
- Current Registered Nurse licensure in the State of Texas or
ENVIRONMENTAL AND PHYSICAL REQUIREMENTS
* Works in temperature controlled environment.
* Must be able to read, write and speak English fluently, have
cognitive skills for math, reading, filing and sterile technique
skills. Vision for near, mid-range, far and accommodation. Hearing
for low, medium, and high pitch.
* Communication skills to deal well with employees, patients,
families and physicians.
* Requires physical ability for standing/walking for long hours,
sitting, crouching, kneeling, reaching above head and below
* May be required to move heavy equipment or assist in moving
* The ability to work with group or team.
* Must deal calmly and effectively with high stress situation.
* Potential risk of exposure to blood-borne
Keywords: Surgery Partners, Lubbock , RN Case Manager, Executive , Lubbock, Texas
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