Full-Time RN Case Manager | Texas

Job Title:

Registered Nures (RN) Case Manager

Academic Background:

• Monday through Friday, 8:30am - 4:00pm

• Actively work with ER/Hospitalist for any new obs/admission request to ensure proper status from admission.
• Ensures compliance with Condition of Participation (CoP) discharge planning.
• Identifies and escalates gaps/barriers related to inpatient and observation length of stay.
• Attend Patient/Family meetings as needed.
• Assesses patients at high risk for readmission. Identifies root cause for readmission. Develops plan and collaborates with multidisciplinary team regarding discharge planning to next level of care.
• Provides discharge care coordination for HHS, Hospice, ALF, and SNF. Communicates with health unit coordinator for appointments/follow ups and therapy re: DME needs prior to and upon discharge.
• Participates with other members of team regarding opportunities for improvement in standard work.
• Actively participates in utilization management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
• Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient s age-specific needs and clinical needs as described in the departments Scope of Service.
• Performs other duties as assigned.

• Utilization review on an ongoing basis.
• Lead monthly UR meeting includes monthly reports with trends and input. This will also be sent to CEO, CFO, CNO, and Hospitalist director + Med Surg manager.
• Aid in Insurance authorization coordination.
• Weekly meeting prn with PFS regarding authorizations and denied claims.
• Denial coordination with the business office on hospitalized patient denials.
• Coordinate peer to peer requested by the business office and provide the business office supportive clinical information.
• Prepare for Monthly UR meetings including monthly reports with trends and input.

• 3+ years experience in prior case manager experience in the inpatient setting.
• Graduate of accredited school of nursing or education equivalency for licensing
• Proficiency with case management software platforms - InterQual and Milliman
• Excellent written and verbal communication skills.

• Work from Home, get the time back spent traveling to and from work.
• Join a group of passionate individuals with a vision of Healthcare Equality.

About Beam Healthcare:

Beam Healthcare is looking for an RN Case Manager to join our growing team of providers, administrators, analysts friends who share the vision of Healthcare Equality. Our partnerships with all types of healthcare organizations are strengthened by our commitment to providing quality-based care with a team-based approach.

Our motto of Telemedicine Moving Forward signifies a proactive approach to system change,whereby we enhance patient care in communities we serve by implementing evidence-based,innovative solutions. This allows us to exceed quality goals while building a strong foundation for the future of medicine. The future of medicine is not limited by social or geographical boundaries. Are you ready to extend the reach of your expertise