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High Risk OB RN Care Manager

Company: Providence Health & Services
Location: Lubbock
Posted on: June 23, 2022

Job Description:

RN Care Manager - Medicaid Hlth ManagementLocation: Lubbock, TXSchedule: Full time - 80 Biweekly HoursShift: 8-hour, DaysComprehensively plans for case management services for a targeted patient population. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels of care. Works with physician, Social Worker and interdisciplinary team to facilitate clinical pathways and achievement of desired treatment outcomes. Promotes interdisciplinary collaboration and champions service excellence. Works collaboratively to ensure patient needs are met and care delivery is coordinated across the continuum at the appropriate level of care.Minimum Qualifications:

  • Bachelor's Degree - required for RN Clinical Audit and Denial Care Manager: Nursing.
  • 1 year experience as a case manager in a hospital setting, managed care setting or clinical setting.
  • Experience with the use of nationally recognized medical necessity screening tools.
  • Significant experience in the healthcare field, including 3 years of Utilization Review/Case Management experience in an acute care or managed care setting.
  • 2 years of experience in the denial management process preferred.
  • Experience in the application of medical necessity screening criteria tools (MCG and/or InterQual).
  • Current licensure in Texas or an approved compact state as a Registered Nurse or proof of application for licensure.Preferred Qualifications:
    • Bachelor's Degree in Nursing/healthcare related field.
    • 3 years Direct patient care experience in an acute care hospital in a leadership role.
    • Case management or utilization management experience.Our best-in-class benefits ( are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission ( of caring for everyone, especially the most vulnerable in our communities.Covenant Health is celebrating over 100 years of serving Lubbock and our South Plains region. As the oldest and largest health system in Lubbock and the region, we currently employ over 5,200 people with a medical staff of over 600 physicians.For over 100 years, Covenant has been driven by a mission of providing a Christian ministry of healing and caring for the whole person - mind, body and spirit. Our vision and differentiator is we are the only faith-based, integrated health network in the West Texas/eastern New Mexico region dedicated to a Christian ministry of healing.As an expression of our mission, we believe we hold an important Covenant with our patients and try and treat every interaction as Sacred Encounters.Our ministry includes six hospitals with over 1,100 licensed beds:Covenant Medical Center - CMCCovenant Children'sCovenant SpecialtyCovenant Plainview - PLVCovenant Levelland - LVLTrustpoint (joint venture: Rehab Hospital of Lubbock)Covenant Medical Group (CMG)Covenant Health PartnersHospice of LubbockCovenant Health's total service area includes 25 counties that covers most of West Texas and eastern New Mexico. The service area covers approximately 750,000 people and approximately 35,000 square miles.Covenant provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Covenant complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Positions specified as "on call, per diem" refers to employment consisting of shifts scheduled on as "as needed basis" to fill in for staff vacancies.Company: Covenant HealthCategory: Case ManagementReq ID: R362308

Keywords: Providence Health & Services, Lubbock , High Risk OB RN Care Manager, Healthcare , Lubbock, Texas

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