Tenet Healthcare Corporation

Registered Nurse Case Manager Lead (RN)

Tenet Healthcare Corporation • $80K — $95K *
Phoenix, AZ 85032In-Person
Healthcare
Less than 5 years of experience
Reposted Today
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Job Overview by Ladders

Qualifications

  • Nursing Degree from an Accredited Nursing School
  • MIDAS, CuraSpan and InterQual Certified Instructor with proficiency testing
  • Minimum of 3 years acute care hospital experience
  • 2 years recent acute care hospital case management experience
  • Current Registered Nurse License in Arizona

Responsibilities

  • Conduct comprehensive discharge needs assessments beginning at admission
  • Coordinate discharge planning with social workers and interdisciplinary teams
  • Provide training for new staff and departmental staff education
  • Initiate social services or specialty referrals in a timely manner
  • Ensure compliance with federal regulations during utilization review

Benefits

  • Medical, dental, vision, and life insurance
  • 401(k) retirement savings plan with employer match
  • Generous paid time off
  • Career development and continuing education opportunities
  • Employee Assistance program and discounts on various services
Full Job Description
Job Description

Position Summary

The position manages the continuum of care for assigned patients and serves as the content expert and role model for department staff. The Lead Case Manager serves as the expert in all aspects of the role including care coordination, collaboration and facilitation, advocacy for patients and families, discharge planning and utilization review. The position serves as the department expert aka "Super User" of MIDAS, CERMe, Curaspan, Portal and MS4. The Lead Case Manager has the primary responsibility for training new staff and providing education to all department staff when new initiatives are implemented. The position provides initial and annual InterQual training for RN Case Managers.

Responsibilities

  • Discharge Planning - Utilize the nursing process to conduct a thorough assessment of discharge needs beginning at admission and as care needs evolve to assure a seamless and safe patient transition to the most appropriate level of care that has the identified resources to meet the medical, nursing and psychosocial needs of the patient. The RN Case Manager works with the physician who is the decisive authority in the referral, transfer or discharge of his/her patient to another level of care. The RN Case Manager collaborates with the interdisciplinary team to implement the identified discharge plan.

    Accountability / Responsibility:
    • Develops and effectively utilizes a network of information regarding community resources
    • Coordinates the discharge planning process in collaboration with social workers and/or other professional members of the interdisciplinary team.
    • Appropriately delegates within the scope of practice discharge planning activities / functions and supervises others involved with discharge planning including LPNs, Case Management Coordinators or other non-licensed personnel performing discharge planning activities.
    • Identifies the appropriate post hospitalization care and services required.
    • Develops post hospital plan of care with the patient and / or family, physician and external resources.
    • Communicates and documents discharge planning needs.
    • Initiates appropriate and timely social services, palliative care or other specialty referrals.
    • Provides necessary patient teaching relevant to discharge needs, post hospital care arrangements prior to discharge.
    • Assesses the patient prior to discharge to determine if the plan is appropriate and makes necessary revisions.
    • Keeps the interdisciplinary care team informed re: details of the discharge plan including printing updated Midas notes and placing on chart.
    • Communicates essential information to the next care provider as described in the hospital discharge planning policy.
    • Educates patient regarding their Medicare appeal rights and initiates the Detailed Notice of Discharge (DND) when the patient decides to appeal their discharge.
    • Contacts the Quality Improvement Organization (QIO) per established protocol detailed in the Hospital Issued Notice of Non-Coverate (HINN).
  • Utilization Review. Consistently applies the utilization review process as required by the Code of Federal Regulations including the use of Abrazo designated criteria for primary review. Incorporates into the utilization review process the ability to access and interpret clinical information against the designated review criteria to reach correct admission status determinations. Has the current knowledge of applicable regulations and laws pertaining to the major payers including Medicare, Medicaid, and other payers. Works with the interdisciplinary team to ensure that the care and services provided are medically necessary, cost effective, delivered efficiently and timely, and at the appropriate level of care to meet payer requirements and established financial/performance benchmarks for the facility and Abrazo.

    Accountability/Responsibility:
    • Coordinates internal and external services to avoid under or over utilization of resources.
    • Indicates the working DRG in MIDAS or other tools.
    • Facilitates or participates in interdisciplinary team meetings or rounds.
    • Reviews record including physician orders and documents admission, concurrent discharge reviews and retrospective reviews as assigned.
    • Communicates with physicians regarding the level of care or admission status when appropriate criteria are not met for inpatient, observation or continued stay.
    • Refers cases to Physician Advisor according to policy and documents the referral.
    • Reviews Observation status patients within 16 hours of admission and obtains appropriate orders based on
    • patients' clinical condition.
    • Notifies admissions office of errors/changes in patient data including changes in physician orders/incorrect admission status designation.
    • Identifies and documents avoidable days and denials.
    • Initiates the appropriate letter (HINN: admission or continued stay, ABN) for any Medicare beneficiary if the outcome of the Physician Advisor secondary review indicates that the patient does not meet inpatient admission/observation status or continued stay medical necessity criteria.
    • Provides and documents concurrent reviews or other information requested by the payer within required timeframes.
    • Documents insurance authorizations received in Midas or on the UM Worksheet


Qualifications

  • Minimum Requirements
    • Education:
      • Nursing Degree from an Accredited Nursing School.
      • MIDAS, CuraSpan and InterQual Certified Instructor (IQCI) training with proficiency testing
    • Experience: Minimum of 3 years acute care hospital experience required and 2 years recent acute care hospital case management, discharge planning and utilization management experience.
    • Licensure/Certifications: Current Registered Nurse Licensed in the State of Arizona
    • Special Skills: The critical knowledge base of nursing process, continuum of care and case management
    • methods and standards, excellent communication and documentation skills. Demonstrates knowledge of Age-Specific Criteria, American Nurses Association (ANA) Nursing Scope and Standards of Practice, ANA Code of Ethics for Nurses, Arizona Nurse Practice Act, Core Measures and American Case Management Association (ACMA) Case Management Standards of Practice.
  • Preferred Requirements:
    • Education: Bachelor of Science in Nursing
    • Experience: 3-5 years experience in acute care hospital Case Management,


    Utilization Management and Discharge Planning and 1

    year hospital supervisory experience. Public speaking and adult education experience preferred.

    • Certification/Registrations: Certified Case Manager, CCM or Accredited Case Manager, ACM.


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About the Team

Abrazo Central Campus has provided hospital care in Central Phoenix since 1963. As a 221- bed acute care and teaching hospital, we offer a complete range of healthcare services including emergency care, family medicine, cardiology and more. Join our team!

About Tenet Healthcare Corporation

Tenet Fintech Group is an innovative Fintech service provider to the Chinese commercial lending sector.

Tenet Healthcare Corporation Careers

Join the dedicated team at Tenet Healthcare Corporation, a national leader in healthcare services. At Tenet, we are committed to providing the highest quality care and outstanding patient experiences. This commitment extends to our team members in every role across our network.

Work You’ll Do

At Tenet Healthcare Corporation, you will be part of a dynamic team that is passionate about transforming healthcare. Our professionals enjoy a collaborative environment where innovative ideas and a proactive approach to healthcare are at the forefront of what we do.

Explore Job Opportunities and Growth

We offer a variety of job opportunities across clinical, administrative, and corporate disciplines. Whether you are a seasoned professional or just starting your career, Tenet provides a path for growth and development. Our leadership is committed to nurturing talents through advanced training programs, leadership workshops, and continuous professional development.

Innovate and Lead

Join us and contribute to a culture of innovation and continuous improvement. At Tenet, every team member is empowered to make a difference. With access to cutting-edge technology and a network of professionals, you will have the tools to drive real change in healthcare delivery.

Diversity and Inclusion

At Tenet Healthcare Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. Our diversity training ensures that our team is respectful, inclusive, and equipped to support the diverse communities we serve.

Internship Programs

Kickstart your career with Tenet’s internship programs. These opportunities allow you to gain hands-on experience while working alongside seasoned professionals. Internships are a great way to develop skills, enhance your resume, and build a network within the healthcare industry.

Benefits and Culture

Our employees enjoy a range of benefits designed to support their physical, financial, and emotional well-being. Join a company that values work-life balance, provides competitive healthcare benefits, and supports your personal and professional growth.

Join Our Team

Are you ready to advance your career in a vibrant healthcare environment? Explore the positions available at Tenet Healthcare Corporation and find where your skills and passion can make a difference. We are actively hiring and looking for individuals who are curious, creative, and eager to drive innovation in healthcare.

Stay Connected

Keep up to date with the latest at Tenet by following our careers blog. Gain insights from our team, learn about our culture, and get tips for your job search and career development.

Networking and Professional Development

At Tenet, networking and professional development are part of our ethos. We encourage our employees to connect, share, and grow together. Enhance your career through comprehensive training, mentorship, and collaboration across our extensive healthcare network.

Apply Now

Discover the rewarding career opportunities at Tenet Healthcare Corporation. Personalize your job search and apply for positions that match your qualifications and interests. Join us in our mission to provide quality care and make a positive impact in the lives of our patients and communities.

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Learn more about Tenet Healthcare Corporation
Size
76,836 employees
Market Cap
$5.1 billion
Industry
Healthcare
Net Income
$399 million
Founded
1967
5 Year Trend
-0.1%
Revenue
$17.6 billion
NASDAQ
THC
* Ladders Estimates

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